What did the study look at?
The upper end of the thigh bone (proximal femur) contains structures used as landmarks in many orthopaedic operations. One of the bony prominences here, the lesser trochanter, is where the hip flexor muscles attach; the authors note it is used as a reference for setting the rotation of the implant stem in hip replacement and femoral neck fracture surgery.
According to the authors, although there are many studies of the greater trochanter and the femoral head and neck, very few have examined how the lesser trochanter relates to these structures. This study investigated that relationship.
How was it done?
- This was an anatomical study on dry bones and included no patient data.
- 67 dry adult femurs of unknown sex (32 left, 35 right) from the Department of Anatomy, Ankara University Faculty of Medicine, were used.
- Bones with deformity of the head, neck or trochanters, signs of fracture, or erosion preventing measurement were excluded.
- Three measurements were taken with a calliper and goniometer: the distance between the tips of the lesser and greater trochanters, the angle between the lesser trochanter tip and the centre of the femoral neck, and the distance between those two points.
What did it find?
- The distance between the lesser and greater trochanter tips averaged 67.5 ± 4.9 mm (60–75 mm).
- The angle between the lesser trochanter tip and the femoral neck centre averaged 35.05° ± 5.06° (29°–42°).
- The lesser trochanter lay on average 15 ± 2.8 mm (10–20 mm) below the centre of the femoral neck.
- Correlations between the distance, angle and height measurements were weak and not statistically significant.
The authors' conclusion
The authors conclude that the angular relationship of the lesser trochanter with the femoral neck, and its distance from the greater trochanter and the neck, are anatomical relationships worth noting for this surgical landmark. They state that the lesser trochanter shows rotational variation between individuals, which should be taken into account especially in operations using a femoral stem, and recommend detailed assessment of patients undergoing hip surgery.
Reference
Akkaya M, Gürsoy S, Şimşek ME, Işık Ç, Acar Hİ, Bozkurt M. The morphologic relationship of the lesser trochanter with the femoral neck and greater trochanter. International Journal of Research in Medical Sciences. 2019;7(2):572–576. Published under a Creative Commons Attribution-NonCommercial (CC BY-NC) licence.
DOI: 10.18203/2320-6012.ijrms20190023
Free full text: International Journal of Research in Medical Sciences (PDF)
This article summarises a published scientific paper for general information; it does not replace an examination or a personal medical assessment. Please consult your doctor about your symptoms.
