ABSTRACT
Background: The anatomy of the proximal femur comprises important landmarks for many orthopedic surgical procedures. However, this area exhibits morphological differences depending on race, gender and age. Besides being the insertion area of the hip flexor muscles, the lesser trochanter is also used as an angular reference in many orthopedic surgical procedures. The aim of this study is to investigate the morphologic relationship of the lesser trochanter with the femoral neck and greater trochanter.Methods: Around 67 dry femur bones (32 left, 35 right) belonging to humans of unknown gender that belong to the Ankara University Medical Faculty, Department of Anatomy were used in this study. The morphologic relationship of the lesser trochanter (TRMI) with the femoral neck (FN) and greater trochanter (TRMJ) was studied and the results were provided in a table.Results: The measured mean lesser trochanter and greater trochanter tip distance was 67.5±4.9mm (60mm-75mm). The angle between the tip of the lesser trochanter and the center of the femoral neck was measured as 35.050±5.060 (290-420) degrees. The distance between the tip of the lesser trochanter and the center of the femoral neck was measured as 15±2.8mm (10mm-20mm).Conclusions: In addition to the angular relationship of the lesser trochanter with the femoral neck, its relationship in terms of distance with the greater trochanter and femoral neck are the anatomic relationships that are noteworthy for the lesser trochanter, which is used as a landmark during orthopedic surgical procedures.
ABSTRACT
OBJETIVOS: Durante o tratamento de fraturas fechadas do colo do metacarpo do dedo mínimo (fraturas do boxeador) usando fixação percutânea com fio K transversal e outros procedimentos, pode ocorrer lesão iatrogênica do ramo digital dorsal do dedo mínimo (RDDDM) do ramo dorsal do nervo ulnar (RDNU). Neste estudo, visamos descrever a relação do RDDDM do RDNU e os pontos de inserção na face lateral do quinto metacarpo durante fixação percutânea com fio K transversal de fraturas subcapitais. MÉTODOS: Foram realizadas dissecações e medições desse ramo depois de colocação de pino transversal percutâneo na parte distal do quinto osso do metacarpo em dez mãos de cadáveres fixadas em formalina. RESULTADOS: Os resultados desse estudo confirmam a grande proximidade da trajetória do pino e desse ramo, e demonstram sua possível lesão iatrogênica durante a fixação do fio K no quinto metacarpo. CONCLUSÕES: Para evitar a penetração desse nervo e limitar as chances de lesão iatrogênica, é importante conhecer o trajeto desse nervo. Os autores descrevem os pontos de inserção anatômica e acreditam que com uso do conhecimento da anatomia das fraturas subcapitais do quinto metacarpo, elas podem ser tratadas sem risco de déficits sensoriais futuros.
OBJECTIVES: When treating closed fractures of the neck of the little finger metacarpal (boxer fractures) with percutaneous transverse K-wire fixation and other procedures, there may be iatrogenic injury to the dorsal digital branch to the little finger (DDBLF) of the dorsal branch of the ulnar nerve (DBUN . In this study we aimed to describe the relationship of the DDBLF of the DBUN and the insertion points on the external side of the fifth metacarpal during percutaneous transverse K-wire fixation of subcapital fractures. METHODS: Dissections and measurements regarding this branch were performed after percutaneous transverse pinning to distal part of fifth metacarpal bones in ten cadaver hands formalin fixed. RESULTS: The results of this study confirm the close proximity of the trajectory of the with this branch and demonstrate its potential iatrogenic injury during K-wire fixation of the fifth metacarpal. CONCLUSIONS: To avoid penetration of this nerve and limit the chances of iatrogenic injury it is important to know its course. The authors describe the anatomical insertion points and believe that using the anatomical knowledge, subcapital fifth metacarpal fractures can be treated without risk of sensory deficits.