Radiologic Measurement Of Angle And Distance Between Anterior Intertrochanteric Line And Posterior Intertrochanteric Line

Objective:Femoral fracture, which is clinically one of orthopedic common and frequently occurring disease of orthopedics, would lead to blood, shock and the fat embolism syndrome. Therefore, it should be treated actively. Usually, femoral fracture is treated by operation. Now, many scholars hold the opinion with their clinical experience that intramedullary fixation can shorten the operation time obviously and injure less, what’s more, with it, the Intraoperative and postoperative complications is low and it is only a short time for the fracture to be healed. Therefore, the current mainstream method for treating is the closed reduction and internal fixation with intramedullary nail.In the closed reduction and internal fixation surgery, if proximal femoral rotation causes poor proposed line, that would often cause iatrogenic complications, such as traumatic arthritis and bone nonunion, which will influence the patient’s postoperative functional exercise and recovery as well as the most basic physiological function. The non-specific symptoms is that patients can not do daily actions of the backbone rotation stress of fracture. The patients have troubles and pains when they go upstairs and downstairs and when they crouch down to the limb weight. Therefore, the problems of whether the proximal femoral rotation occurs, the rotation angle and how to adjust the rotation become the most important. At present, there is no clear clinical and objective data for judgment of proximal femur rotating force line. The doctor who does the operation conjectures from their experiences, but this method is full of subjective elements and there is no specific data to support it, therefore, after the operation, many patients would have deformities of femoral rotation force line. In anatomy, the femoral greater trochanter and small rotor at the bottom of the femur are the significant anatomical marks. Now, the scholars have proved that:that the hight and width of small rotor which changes with femoral rotation angle would change has been applied earlier to the judgment of femoral rotation state. And the relation between the big rotor and femoral rotation status has also been studied. This experiment aims to looking for proximal femur anatomic marks which is regarded as the basis for judging the proximal femoral rotation angle. After the statistics analysis, the equation of the straight line is come out to guide the intraoperative C arm positioning and operation effect. By picturing the X-ray of11femoral specimens which is in the neutral position, internal rotation5°,10°,15°、20°and external5°,10°,15°,20°, we make a research of the morphological change under the different rotation angle of relation between before and after the line of proximal femoral trochanter, put forward the concept of distance and angle between lines of around femoral trochanter and record the values and analyze the relations between the distance and angle and rotation angle. By summerizing the relation, we can have the rotation of the femur and guide the correction of lower limb rotation force of closed reduction and femoral fracture line.Methods:Due to the fact that it is easy to see the longitudinal trends of the femoral marrow cavity and the proximal anatomical structure from the X-ray, it becomes a widely used method of studying the proximal femur geometry according to the femur x research. We selected11femoral specimen and put the femoral on the flat, making sure that the femoral condyle and lateral femoral in the same level, picture the X-ray of11femoral specimens which is in the neutral position, internal rotation5°,10°,15°、20°and external5°,10°,15°、20°. Because there would be errors with pure rotation of the femur, we chose the ball tube launcher of DR to reach the goal. After getting the X-ray, with the help of surveying and mapping tools of E-RULER, we had the tuberosity Angle between lines and maximum distance. With SPSS statistical software, we make the analysis.Results:The angle and distance between anterior intertrochanteric line and posterior intertrochanteric line increased with external rotation and decreased with internal rotation and the values showed statistical significance between different positions. Femoral shaft rotation angle=1.801x A-25.111(r=0.947P<0.05); Femoral shaft rotation angle=43.309x R-21.620(r=0.931P<0.05),A represent angle between anterior intertrochanteric line and posterior intertrochanteric line, R represent distance between anterior intertrochanteric line and posterior intertrochanteric line. Rotation Angle=X1.801-25.111(r=0.947P<0.05); Rotation Angle=43.309X distance between anterior intertrochanteric line and posterior intertrochanteric line-21.620(r=0.931P<0.05).Conclusion:Angle and distance between anterior intertrochanteric line and posterior intertrochanteric line is linearly related to femoral rotation and could be used as a reference for prevention of femoral malalignment during surgery.