Measurement of the Axial Rotational Axis of Distal Femur Using Different Landmarks

PURPOSE: To know the discrepancy of rotational alignment using human femur. MATERIALS AND METHODS: We used 22 adult human femurs which were not able to distinguish age and sex and absent articular cartilage. In a horizontal plane, we made a cross-section perpendicularly at supra-condyle of femur to a mechanical axis and took a simple roentgenogram in coronal plane focusing on the center of transepicondylar axis. In terms of roentgenogram and gross specimen, the angle between per-pendicular to the anteroposterior axis and the posterior condylar axis, the angle between the transepi-condylar axis and the posterior condylar axis were measured by 5 observers. According to t-test in statisti-cal method, we figured out the difference between two angles and made a significance at p<0.05. RESULTS: About posterior condylar axis, the line perpendicular to anteroposterior axis was observed the average 4.8(+/-1.5)degree, 6.0(+/-1.9)degree external rotation in roentgenogram and gross specimen respectively. The transepicondylar axis was observed the average 3.5(+/-1.2)degree, 3.9(+/-1.4)degree external rotation in roentgenogram and gross specimen respectively. There was statistically significant difference between two angles. Moreover, angles measured by 5 observers were found that to have a line perpendicular to the anteroposterior axis has much more external rotation respectively and there was a statistically significant difference also. CONCLUSIONS: On determination of a rotational alignment using human femur, there is statistically sig-nificant difference between the anteroposterior axis and the transepicondylar axis in gross specimen as well as roentgenogram.

Femoral Neck Fracture Fixation (Comparison of Dynamic Hip Screw and Cannulated Screw Fixation) / 대한정형외과학회잡지

PURPOSE: To evaluate the difference between dynamic hip screw and cannulated screw for stability, complication and patient s functional recovery in intracapsular fracture of femoral neck. MATERIALS AND METHODS: Eight-four patients were randomly assigned into dynamic hip screw fixation and cannulated screw fixation groups. Clinical information included age and sex distribution, operation time, total blood loss, interval from injury to operation, etiology of fracture, associated fracture, and functional outcome. Preoperative X-ray information included fracture type by Garden stage, Singh index, and posterior comminution. Postoperative information included quality of reduction, pin and screw position, Garden alignment index, evidence of union, complication and failure. RESULTS: No difference was noted between the two fixation methods regarding gender, initial fracture displacement, postoperative reduction or position of the fixation device, functional outcome using Robinson's method, and complication. In operation time and total blood loss, however, cannulated screw fixation group was significantly lower (P<0.05). CONCLUSIONS: Therefore, to decrease operation time and blood loss, cannulated screw fixation was considered to be more useful as a fixation method in a intracapsular fracture of femoral neck.