The Journal of Bone and Joint Surgery, Vol 69, Issue 8 1169-1176, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Femoral anteversion
SB Murphy, SR Simon, PK Kijewski, RH Wilkinson and NT Griscom
Department of Orthopedic Surgery, Children's Hospital Medical Center, Boston, Massachusetts 02115.
Biplane roentgenography, axial roentgenography, and fluoroscopy are the
usual roentgenographic methods of measuring femoral anteversion. These
methods use a strict geometrical definition of anteversion. The
computerized tomography method of measuring anteversion that was developed
recently, and is now widely used, does not adhere to the accepted
definition of anteversion and has not been tested for accuracy in a large
series. In the present study, the widely used computerized-tomography
method of measuring anteversion was tested on thirty-two femoral specimens.
With that method, anteversion was consistently underestimated by an average
of 10 degrees compared with direct measurements and was reproducible only
to within +/- 3.6 degrees. Therefore, a new method of measuring anteversion
using computerized tomography was developed. It was shown to be accurate to
+/- 1 degree, as tested on the same specimens. This study demonstrated
geometrically why the currently practiced computerized-tomography method of
selecting the points that are used to define the axis of the femoral neck
is not consistent with geometrical definitions of anteversion. A more
accurate method for both defining the axis of the femoral neck and
measuring femoral anteversion is described and recommended for clinical
use.
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