股骨近端外侧壁的解剖学研究及其对转子间骨折内固定的意义

doi:10.13418/j.issn.1001-165x.2016.01.011

Abstract

Abstract:

Objective　Proximal femoral lateral wall is defined as the lateral cortex distal to the vastus insertion, which is the entry point to put lag screw/helical blade into femoral head for fixation of intertrochanteric fractures. This study was focused on the bony and soft-tissue of lateral wall anatomy, and aimed to provide reference data for clinical implications.　Method　Sixteen femurs, 10 lower limbs and 20 CT slices in geriatric pertrochanteric fractures were used to measure the bony area (height and width), soft-tissue attachment and intersection (height, width and thickness), and femur lateral cortical thickness at the mid lesser trochanteric level.　Result　The bony lateral wall has a mean height of (24.4±2.4) mm，width of (23.3±2.0) mm，and area of (567.0±82.8) mm2. The attachments of gluteus medius and minus terminal and the vastus origin were mixed and intersected with each other to form a tedious aponeurotic structure together. The soft-tissue lateral wall has a height of (33.2±2.3) mm，width of (28.2±1.9) mm，and thickness of (1.6±0.1) mm. The femoral lareral wall in geriatric patients was very thin, with a cortical thickness of (2.3±0.5) mm.　Conclusion　The lateral wall in geriatrics is very weak and vulnerable to fracture perioperatively. Cephalomedullary nail is superior to DHS for geriatric intertrochanteric fractures.

Key words: Proximal femoral lateral wall, Lateral cortex, Trochanteric lateral wall, Soft-tissue on lateral wall, Intertrochanter fracture

References

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Anatomic study on the proximal femoral lateral wall and its clinical implications for geriatric intertrochanteric fractures

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