DOCSLIB.ORG

The Relationship of Femoral Neck Shaft Angle and Adiposity to Greater Trochanteric Pain Syndrome in Women

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Relationship of Femoral Neck Shaft Angle and Adiposity to Greater Trochanteric Pain Syndrome in Women Original article Br J Sports Med: first published as 10.1136/bjsports-2011-090744 on 30 April 2012. Downloaded from The relationship of femoral neck shaft angle and adiposity to greater trochanteric pain syndrome in women. A case control morphology and anthropometric study Fearon AM,1,2 Stephens S,2 Cook JL,3 Smith PN,1,2 Neeman T,4 Cormick W,5 Scarvell JM2 ▶ Additional tables are pub- ABSTRACT are sex and age,9 10 with older women at greater lished online only. To view the Objective To evaluate if pelvic or hip width predis- risk of developing GTPS. Other possible intrinsic fi les please visit the journal posed women to developing greater trochanteric pain online (http://bjsm.bmj.com/ factors are adiposity and biomechanics. Elevated content/46/12.toc) syndrome (GTPS). adiposity has been proposed as an under rec- Design Prospective case control study. ognised risk factor for all tendinopathies11 sug- 1Department of Medicine, Biology and the Environment, Participants Four groups were included in the study: gesting a systemic mechanism is involved rather Australian National University, those gluteal tendon reconstructions (n=31, GTR), those than mechanical overload.6 Peripheral adiposity, Canberra, Australian Capital with conservatively managed GTPS (n=29), those with (gynoid distribution), appears to be a risk factor Territory, Australia hip osteoarthritis (n=20, OA) and 22 asymptomatic for developing tendinopathy in women.12 To 2 Department of Surgery, The participants (ASC). Trauma and Orthopaedic date, the level of adiposity in GTPS has only been Research Unit, Canberra, Methods Anterior-posterior pelvic x-rays were reported in terms of body mass index (BMI), with Australian Capital Territory, evaluated for femoral neck shaft angle; acetabular index, values ranging from 22.1 kgm−213 to 27.3 kgm−2.14 Australia and width at the lateral acetabulum, and the superior BMI measures the relationship between height 3 Primary Health Care, Monash and lateral aspects of the greater trochanter. Body mass and weight but does not indicate fat distribution, University, Melbourne, Victoria, Australia index, and waist, hip and greater trochanter girth were a key factor in determining the systemic effects of 4Statistical Consulting Unit, measured. Data were analysed using a one-way analysis increased adiposity.15 As there is some evidence Australian National University, of variance (ANOVA; posthoc Scheffe analysis), then to suggest increased adiposity is a risk factor for Acton, Australian Capital multivariate analysis. developing tendinopathy in women, the rela- Territory, Australia Results The GTR group had a lower femoral neck 5Canberra Specialist tionship of adiposity and GTPS deserves further Ultrasound, Deakin West, shaft angle than the other groups (p=0.007). The OR investigation. Australian Capital Territory, (95% CI) of having a neck shaft angle of less than 134°, Other intrinsic risk factors for developing GTPS Australia relative to the ASC group: GTR=3.33 (1.26 to 8.85); that have been reported in review papers and GTPS=1.4 (0.52 to 3.75); OA=0.85 (0.28 to 2.61). The textbooks (in runners) include leg length discrep- http://bjsm.bmj.com/ Correspondence to 16 16–19 Fearon AM, OR of GTR relative to GTPS was 2.4 (1.01 to 5.6). No ancy and pelvic width. However, leg length Centre for Hip Health and group difference was found for acetabular or greater discrepancy has not been found to be associated Mobility, 7th Floor, 2635 Laurel trochanter width. Greater trochanter girth produced the with GTPS in people with primary GTPS10 or in St Robert H.N. Ho Research only anthropometric group difference (mean (95% CI) in people who develop GTPS post-total hip arthro- Centre Vancouver, BC, Canada cm) GTR=103.8 (100.3 to 107.3), GTPS=105.9 (100.2 20 V5Z 1M9 plasty. In addition, leg length discrepancy has [email protected] to 111.6), OA=100.3 (97.7 to 103.9), ASC=99.1 (94.7 been reported to be lower in those with GTPS 21 22 to 103.5), (ANOVA: p=0.036). Multivariate analysis than the population prevalence. The evidence on September 24, 2021 by guest. Protected copyright. Received 9 November 2011 confi rmed adiposity is associated with GTPS. of pelvic width as a risk factor is limited to level V Accepted 12 March 2012 Conclusion A lower neck shaft angle is a risk factor for, evidence,16 17 with the authors failing to differen- Published Online First and adiposity is associated with, GTPS in women. tiate between the pelvic, hip or greater trochanter 30 April 2012 width. As GTPS is more common in women, and women have wider pelves than men,23 the research question of whether a wider pelvis is an intrinsic INTRODUCTION risk factor for GTPS should be addressed. Greater trochanteric pain syndrome (GTPS) is Pathological compression of a tendon is thought thought to be a degenerative condition of the to contribute to the development of tendinopa- gluteal tendons and bursa1 2 for which few risk thy.24–26 The angle that the tendon approaches the factors have been identifi ed. Tendinopathies enthesis and the size of the bony pulley before the occur in both sporting and sedentary populations3 tendon insertion affects the strain and compres- indicating a multifactorial aetiology.4–6 These sion forces on the tendon. In the case of the glu- factors include intrinsic and extrinsic risk teus medius and minimus tendons, this angle is factors.5 Identifying risk factors for GTPS should in part determined by the neck shaft angle of the aid in understanding the aetiology of, and direct femur. In addition, greater hip width at the level treatment for, GTPS. of the greater trochanters would result in the glu- Intrinsic risk factors previously identifi ed for teal tendons wrapping over a greater proportion tendinopathies such as patellar and Achilles ten- of the greater trochanter, leading to an increased dinopathy include genetic and biomechanical area of compression.27 Therefore, the degree of factors.7 8 Intrinsic factors associated with GTPS coxa vara and the pelvic width at the level of the 1 of 6 Br J Sports Med 2012;46:888–892. doi:10.1136/bjsports-2011-090744 Original article Br J Sports Med: first published as 10.1136/bjsports-2011-090744 on 30 April 2012. Downloaded from greater trochanter may be a predisposing factor for developing GTPS.24–26 The aims of this study were to evaluate if the width of the pelvis or femoral neck shaft angle constituted independent risk factors, or if in combination of these constituted a risk fac- tor for developing GTPS. A further aim was to determine if increased adiposity and the distribution pattern of the adipos- ity was associated with GTPS. PARTICIPANTS AND METHODS Participants Four groups of participants were recruited; those with GTPS, gluteal tendon reconstruction (GTR; surgical management of GTPS), hip osteoarthritis (OA) and an age and sex matched (to the GTPS group) control group (ASC). Participants were recruited through private healthcare providers and viva voce. All participants had to be older than 18 years of age and able to communicate in English. Participants were excluded if they Figure 1 Schematic illustration of the lines used to measure the had the following: systemic infl ammatory disease, for exam- width of the pelvis and greater trochanters, and the acetabular index. ple, rheumatoid arthritis; lumbar spine nerve root signs; a his- The midline was defi ned as the line perpendicular and bisecting the tory of lumbar spine or ipsilateral hip joint surgery; osteogenic line that joined to two tear drops. (A) The width from the midline to disease, for example, Paget’s disease, or neoplastic disease. the anterior inferior iliac spine – the reference width. (B) The width Due to sex-linked pelvic morphology, men were excluded from from the midline to the most lateral aspect of the acetabulum. (C) this study.23 The width from the midline to the most superior point of the greater trochanter. (D) The width from the midline to the most lateral aspect Hip OA participants were diagnosed according to Altman of the greater trochanter. 199128 and were scheduled for hip arthroplasty surgery. Diagnostic criteria for GTPS was a history of lateral hip pain,22 29 pain on palpation of the greater trochanter and at least one of taken from the midline – a perpendicular line that bisected lateral hip pain with lying on the ipsilateral side, weight bear- the distance between the distal border of the acetabular tear ing activities or sitting.29 30 In addition to the above criteria for drops (ML) to the anterior inferior iliac spine (AIIS) (A); to the GTPS, participants in the GTR group had evidence of tendon lateral rim of the acetabulum (B); to the most superior aspect tearing on MRI or ultrasound imaging, with symptoms refrac- of the greater trochanter (C); and to the most lateral aspect of tory to ultrasound-guided corticosteroid injection and physio- the greater trochanter (D) (fi gure 1). Ratio distances in relation therapy. Control participants had to be asymptomatic for hip to A were calculated for linear measures. The acetabular index joint and tendon pathology. Participants in the GTPS, GTR and was measured according to Sharp’s method31 (fi gure 1). The ASC groups had no evidence of hip OA.28 Participants in the femoral neck shaft angle was measured using a six-inch goni- http://bjsm.bmj.com/ ASC and OA groups had no past or current history of GTPS. ometer (http://www.physiosupplies.com.au 15 May 2011) on Clinical status was confi rmed by examination using the above the digital x-ray, aligning the goniometer arms along the shaft criteria (AF).
Load more

Recommended publications
  • A New Caenagnathid Dinosaur from the Upper Cretaceous Wangshi
    www.nature.com/scientificreports OPEN A new caenagnathid dinosaur from the Upper Cretaceous Wangshi Group of Shandong, China, with Received: 12 October 2017 Accepted: 7 March 2018 comments on size variation among Published: xx xx xxxx oviraptorosaurs Yilun Yu1, Kebai Wang2, Shuqing Chen2, Corwin Sullivan3,4, Shuo Wang 5,6, Peiye Wang2 & Xing Xu7 The bone-beds of the Upper Cretaceous Wangshi Group in Zhucheng, Shandong, China are rich in fossil remains of the gigantic hadrosaurid Shantungosaurus. Here we report a new oviraptorosaur, Anomalipes zhaoi gen. et sp. nov., based on a recently collected specimen comprising a partial left hindlimb from the Kugou Locality in Zhucheng. This specimen’s systematic position was assessed by three numerical cladistic analyses based on recently published theropod phylogenetic datasets, with the inclusion of several new characters. Anomalipes zhaoi difers from other known caenagnathids in having a unique combination of features: femoral head anteroposteriorly narrow and with signifcant posterior orientation; accessory trochanter low and confuent with lesser trochanter; lateral ridge present on femoral lateral surface; weak fourth trochanter present; metatarsal III with triangular proximal articular surface, prominent anterior fange near proximal end, highly asymmetrical hemicondyles, and longitudinal groove on distal articular surface; and ungual of pedal digit II with lateral collateral groove deeper and more dorsally located than medial groove. The holotype of Anomalipes zhaoi is smaller than is typical for Caenagnathidae but larger than is typical for the other major oviraptorosaurian subclade, Oviraptoridae. Size comparisons among oviraptorisaurians show that the Caenagnathidae vary much more widely in size than the Oviraptoridae. Oviraptorosauria is a clade of maniraptoran theropod dinosaurs characterized by a short, high skull, long neck and short tail.
    [Show full text]
  • Percutaneous Reduction Techniques
    AAOS 2016 Specialty Day Orthopaedic Trauma Associacion (OTA) Percutaneous Reduction Techniques Christian Krettek Trauma Department, Hannover Medical School, Germany [email protected] www.mhh-unfallchirurgie.de Short segment tibial fractures can be stabilized using different implants like plates, screws, external fixators and nails. This syllabus deals mainly with reduction techniques in the context of the use of intramedullary nails. 1.1 PREOPERATIVE PLANNING AND MANAGEMENT 1.1.1 Primary shortening and secondary overdistraction eases definitive nailing In the acute setting primary shortening of a shaft fracture is a helpful strategy to de- crease soft tissue tension and intra-compartmental pressure. However, reduction gets more difficult and more time consuming, the longer the fracture is kept in a shortened position. The concept of primary shortening (acute phase) and secondary (after 3 or 4 days) overdistraction eases definitive nailing. Using a electro-mechanical load cell, our group has compared the reduction forces in patients undergoing femoral nailing after Damage Control in shortend vs overdistracted fracture configuration. In the overdistrac- tion group, the reduction forces were lower (200 N +/-43.1 N vs. 336 N +/- 51.9 N, p = 0.007) and the reduction time was shorter (5.8 min +/-4.0 min vs. 28.3 min +/-21.8 min, p = 0.056). It was concluded, that DCO with the fracture shortened leads to higher restrai- ning forces & prolonged reduction time. Overdistraction should be performed as soon as possible under careful soft-tissue monitoring [1a, 2a]. Primary shortening and secondary overdistraction eases definitive nailing Example of a femoral shaft fracture stabilized in shortening first with an external fixator.
    [Show full text]
  • Congenital Abnormalities of the Femur
    Arch Dis Child: first published as 10.1136/adc.36.188.410 on 1 August 1961. Downloaded from CONGENITAL ABNORMALITIES OF THE FEMUR BY P. A. RING From the Royal College of Surgeons (RECEIVED FOR PUBLICATION NOVEMBER 25, 1960) Congenital defects of the femur vary from simple tion of its incidence is difficult to obtain, but it hypoplasia of the bone to complete absence. appears to be the commonest congenital defect Classification of these defects has been suggested causing major abnormalities of limb growth. by Nilsonne (1928) and by Mouchet and Ibos (1928), but neither has met with general acceptance. In more recent years Golding (1939, 1948) has demon- Clinical Features strated the close association of the short femur with There is no evidence that this is a familial disorder, congenital coxa vara, and has emphasized that and careful inquiry of the parents has revealed no these are variations of the same underlying abnor- evidence of other congenital disorders within the mality. The clinical distinction between the various immediate family. The history of the pregnancy types of femoral defect is important as a guide to and delivery has failed to indicate any significant the prognosis of limb development. infection or abnormality at this time. In most From an examination of patients with congenital patients the abnormality is apparent at birth, but abnormalities of the femur the following classifica- where the inequality of leg length is slight, the by copyright. tion is suggested: diagnosis may not be made until the child begins to 1. Simple femoral hypoplasia. walk. To ordinary clinical testing the abnormality 2.
    [Show full text]
  • Supplementary Table 1: Description of All Clinical Tests Test Protocol
    Supplementary Table 1: Description of all clinical tests Test Protocol description Tibiofemoral • Palpate & mark tibial tuberosity & midpoint over the talus neck frontal plane • Ask participant to stand on footprint map with foot at 10° external rotation, feet shoulder width, looking alignment forward, 50% weightbearing • Place callipers of inclinometer in alignment with the the two landmarks • Record varus/valgus direction in degrees Herrington test • Participant supine on plinth, knee positioned and supported in 20° of knee flexion (to place the patella within the trochlea groove) • With knee in position, place a piece of 1” Leukotape (or similar) across the knee joint, and mark the medial and lateral epicondyles of the femur and mid-point of the patella. Be sure to make note of medial and lateral end of tape • Repeat 3 times, attaching tape to this document for measuring later 30 second chair • Shoes on, middle of chair, feet ~ shoulder width apart and slightly behind knees with feet flat on floor, stand test arms crossed on chest • Instructions “stand up keeping arms across chest, and ensure you stand completely up so hips and knees are fully extended; then sit completely back down, so that the bottom fully touches the seat, as many times as possible in 30 seconds,” • 1-2 practice repetitions for technique • One 30-second test trial • Record number of correctly performed full stands (if more than ½ of way up at end of the test, counted as a full stand) Repetitive single • Shoes on, seated on edge of plinth, foot placed with heel 10 cm forward from a plumb line at edge of leg rise test plinth, other leg held at side of body, arms across chest.
    [Show full text]
  • Endoscopic Repair of Full-Thickness Gluteus Medius Tears Benjamin G
    Endoscopic Repair of Full-Thickness Gluteus Medius Tears Benjamin G. Domb, M.D., and Dominic S. Carreira, M.D. Abstract: Tears in the gluteus medius and minimus tendons recently have emerged as an important cause of chronic greater trochanteric pain syndrome. Increasing recognition of the gluteal insertion as a cause of chronic pain and weakness, as well as technologic advances in endoscopic hip surgery, has made gluteal insertional repair a rapidly emerging technique in minimally invasive surgery of the hip. We present an endoscopic double-row technique for gluteal insertional repair that allows for visualization, debridement, and repair, re-creating the normal footprint. ears in the gluteus medius and minimus tendons most patients respond favorably.7 A survey of French Trecently have emerged as an important cause of surgeons reporting the results of open repairs in 29 chronic greater trochanteric pain syndrome. Histori- patients showed 12 excellent results, 6 good outcomes, cally, pain over the greater trochanter was presumed and 11 poor outcomes.9 Endoscopic techniques have solely to be due to bursitis, but several studies have included gluteal debridement or repairs, bursectomy, challenged this and shown gluteus tears as a source of and iliotibial band release.10 Voos et al.11 described pain.1 Degenerative tears occur more often than acute a technique of endoscopic repair of the gluteal insertion tears,2,3 and gluteus medius tears occur more often with complete relief of symptoms in 10 patients. The than gluteus minimus tears.4,5 Tears at the insertion of advantages and limitations of endoscopic repair of the the gluteus medius can be intrasubstance, partial, or gluteus medius are described in Table 1.
    [Show full text]
  • The Greater Trochanter Triangle
    Occasional piece Br J Sports Med: first published as 10.1136/bjsm.2007.042325 on 19 November 2008. Downloaded from The greater trochanter triangle; a pathoanatomic approach to the diagnosis of chronic, proximal, lateral, lower pain in athletes E C Falvey,1 A Franklyn-Miller,1 P R McCrory2 1 Centre for Health, Exercise and ABSTRACT THE GREATER TROCHANTER TRIANGLE Sports Medicine, School of Chronic pain experienced in the proximal, lateral, lower The specific anatomical landmarks and borders of Physiotherapy, Faculty of Medicine, Dentistry and Health limb may arise from the femoro-acetabular joint, from the the greater trochanter triangle are set out in fig 1. Sciences The University of muscles and tendons that act upon it, from any of the Melbourne, Victoria 3010 structures that traverse the area, and from more remote Australia and Olympic Park structures such as the lumbar spine. Sports Medicine Centre, The aetiology of pathology in this area is not confined to Olympic Boulevard, Melbourne 3004, Australia; 2 Centre for either trauma or overuse. As a result many different Health, Exercise and Sports sporting activities may have a causal role. Medicine University of Without a clear clinical/pathological diagnosis, the Melbourne, Australia subsequent management of chronic groin pain is difficult. Correspondence to: The combination of complex anatomy, variability of Eanna C Falvey, Centre for presentation and the non-specific nature of the signs and Health, Exercise and Sports symptoms makes the diagnostic process problematic. Medicine, School of Physiotherapy, Faculty of The paper proposes a novel educational model based on Medicine, Dentistry and Health pathoanatomic concepts.
    [Show full text]
  • Bone Handout”)
    The Skeletal System (“Bone Handout”) Bone Markings - as in Table 6.1, know categories, names, descriptions and categories of bone markings Common Fractures - as in Table 6.2, identify type from pictures The Axial Skeleton Skull Cranial bones frontal (supraorbital foramen) parietal temporal (mastoid process, external auditory(acoustic) meatus, styloid process, zygomatic process, stylomastoid foramen) occipital (foramen magnum, hypoglossal canal, occipital condyles) sphenoid (optic canal, superior orbital fissure, sella turcica, foramen rotundum, foramen ovale, foramen spinosum , greater wings, lesser wings) ethmoid (olfactory foramina) Relevant Figures: 7.4, 7.6, 7.7a, 7.9 Facial bones nasal maxilla (infraorbital foramen, inferior orbital fissure) zygomatic mandible (mental foramen, body, ramus, mandibular condyle) lacrimal (lacrimal fossa) palatine inferior nasal conchae vomer Relevant Figures: 7.4, 7.6, 7.7a Sutures coronal sagittal lambdoid squamous Relevant Figures: 7.4, 7.5 Paranasal Sinuses frontal sphenoidal maxillary ethmoidal Relevant Figures: 7.15 Fontanels anterior posterior sphenoidal mastoid Relevant Figures: 7.28 Hyoid bone Relevant Figures: 7.17 1 Vertebrae Parts of a “typical vertebra” using thoracic as example body vertebral arch (pedicle, lamina, vertebral foramen) intervertebral foramen transverse process spinous process superior articular process inferior articular process Divisions of vertebral column cervical (transverse foramina) thoracic (transverse costal facet - for tubercle of rib, superior and inferior costal
    [Show full text]
  • Pelvis & Thigh
    Pelvis & Thigh 6 After meeting a stranger, you soon begin to palpate their piriformis Topographical Views 276 muscle (located deep in the posterior buttock). You certainly wouldn’t try Exploring the Skin and Fascia 277 this in “everyday life,” but in patient care settings this level of familiarity is Bones of the Pelvis and Thigh 278 commonplace—and welcomed by a client with a hypercontracted piriformis. Bony Landmarks of the Pelvis Touch is a unique privilege afforded to health care providers. As such, we and Thigh 279 need to be mindful of the trust our clients have in us. One way to insure this Overview: Bony Landmark Trails 284 is through good communication skills. For instance, working the adductors Overview: Muscles of the and gluteal region requires a practitioner to provide ample explanation as to Pelvis and Thigh 296 the rationale, need, and goals of working these intimate areas of the body. Synergists—Muscles Working This chapter might pose new challenges for you, as we will be palpating Together 302 structures close to intimate areas. Muscles of the Pelvis and Thigh 306 Ligaments and Other Before proceeding, consider the following questions: Structures of the Pelvis and Thigh 336 E Have you ever been anxious to undergo a physical exam? Was there anything the practitioner did or could have done to alleviate this anxiety? Consider multiple elements, including both verbal and nonverbal communication, draping, physical pressure, and pace. E Tissues and landmarks found in the pelvis and thigh tend to be significantly larger than those discussed in previous chapters. How might your palpation techniques need to change? E Also, how might you properly and comfortably position your patient to access structures needing to be palpated.
    [Show full text]
  • Morphological Variation of the Proximal Femur in Selected Skeletal Remains
    MORPHOLOGICAL VARIATION OF THE PROXIMAL FEMUR IN SELECTED SKELETAL REMAINS A Thesis by Jessica Lynn Brown B.S. Michigan State University, 2002 Submitted to the College of Liberal Arts and Sciences and the faculty of the Graduate School of Wichita State University in partial fulfillment of the requirements for the degree of Master of Arts May 2006 MORPHOLOGICAL VARIATION OF THE PROXIMAL FEMUR IN SELECTED SKELETAL REMAINS I have examined the final copy of this thesis for form and content and recommend that it be accepted in partial fulfillment of the requirements for the degree of Master of Arts with a major in Anthropology. __________________________________________ Peer H. Moore-Jansen, Ph.D., Committee Chair We have read this thesis and recommend its acceptance: __________________________________________ Robert Lawless, Ph.D., Committee Member __________________________________________ John Carter, Ph.D., Committee Member ii DEDICATION To My Family and Friends iii ACKNOWLEDGEMENTS Funding for this research came from three generous sources. Dr. Todd Fenton provided me with the opportunity to experience Albania’s past and present in two separate field seasons. The Moore-Jansen Scholarship and the Nancy Berner Fund through the Anthropology Department at Wichita State University provided financial support to study the Hamann-Todd collection in Cleveland. The expense of travel and accommodations during data collection during all of these experiences was greatly appreciated by these considerate awards. I would like to thank all the members of my thesis committee, Dr. Peer Moore-Jansen, Dr. Robert Lawless, and Dr. John Carter for their comments and suggestions. Throughout this process Dr. Peer Moore-Jansen provided invaluable guidance on how to conduct and report meaningful research, which will stay with me always.
    [Show full text]
  • Giant Cell Tumour of Greater Trochanter Apophysis: Case Report
    Case report East African Orthopaedic Journal GIANT CELL TUMOUR OF GREATER TROCHANTER APOPHYSIS: CASE REPORT Kinyanjui JW, MBChB, MMed (Orth), Orthopaedic Surgeon, St Mary Rift Valley Mission Hospital, P.O. Box 582-00902, Elementaita, Kenya. Email: [email protected] ABSTRACT Most giant cell tumours of bone occur in the metaphysic of the long bone in the third decade of life. Surgical excision is associated with a high recurrence rate. This case report describes occurrence of a giant cell tumour of bone in the greater trochanter apophysis in a 15 year old male and outlines surgical management strategies employed to reduce the chance of recurrence based on a review of literature. Key words: Giant cell tumor of bone, Greater trochanter apophysis, Intralesion excision INTRODUCTION Figure 1Figure 1 Demarcated lytic lesion approximately 2 cm in Giant cell tumour of bone is a rare neoplasm of greatest Figure diameterDemarcated 1 on the lytic greater lesion trochanter approximately 2 cm in greatest bone that is commonly located in the metaphyses diameterapophysis on the greater trochanter apophysis of the long bones and presents in the third decade Demarcated lytic lesion approximately 2 cm in greatest of life. It is associated with a high recurrence diameter on the greater trochanter apophysis rate after surgical excision. A case of occurrence of a giant cell tumour in an unusual location is presented: the greater trochanter apophysis. This case occurred in a 15 year old male. He underwent surgical excision based on principles shown by available evidence to reduce the high recurrence rate. On 3 months follow up there has been no recurrence.
    [Show full text]
  • The Third Trochanter of Femur - an Anatomical Study
    International Journal of Current Research and Review Research Article DOI: http://dx.doi.org/10.31782/IJCRR.2020.122333 The Third Trochanter of Femur - An Anatomical Study IJCRR 1 1 2 Section: Healthcare Gyanaranjan Nayak , Saurjya Ranjan Das , Sitansu Kumar Panda , Sci. Journal Impact 3 Factor: 6.1 (2018) B Shanta Kumari ICV: 90.90 (2018) 1Associate Professor, Department of Anatomy, IMS and SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, 2 Copyright@IJCRR Odisha 751003, India; Professor, Department of Anatomy, IMS and SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhu- baneswar, Odisha 751003, India; 3Assistant Professor, Department of Anatomy, IMS and SUM Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha 751003, India. ABSTRACT . Background: The third trochanter is a rounded, linear or conical projection along the superior border of gluteal tuberosity of the femur. Purpose of the study is to find the frequency of the third trochanter in human femora and determine its dimensions and its distance from the tip of greater trochanter of the femur. Methods: Sixty dry human femora (thirty right and thirty left) were examined for the presence of third trochanter, their dimen- sions and their distance from greater trochanter being measured by slide calliper. Results: The third trochanter was noted in 21.66 % cases. Their mean length and width were found to be 2.61 ± 0.97 cm and 0.96 ± 0.15 cm respectively. The average distance of the third trochanter from the tip of the greater trochanter was found to be 6.81 ± 0.64 cm. Conclusion: The current study will be useful in anthropometry and orthopaedics.
    [Show full text]
  • Medd 421 Anatomy Project ~
    MEDD 421 ANATOMY PROJECT ~ KURT MCBURNEY, ASSISTANT TEACHING PROFESSOR - IMP NICHOLAS BYERS - SMP PETER BAUMEISTER - SMP Proof of Permission for Cadaveric Photos LABORATORY 1 ~ OSTEOLOGY INDEX Acetabular labrum Gluteal surface Metatarsals (1-5) Acetabulum Greater sciatic notch Navicular Anterior intercondylar area Greater Trochanter Neck of Fibula Anterior superior iliac spine (ASIS) Head of Femur Neck of Talus Calcaneal Tuberosity Head of Fibula Obturator foramen Calcaneus Head of Talus Patellar Surface Cuboid Iliac crest Phalanges Cuneiform Intercondylar eminence Phalanges (medial, intermediate, and lateral) Ischial spine Posterior superior iliac spine (PSIS) Femoral Condyles Ischial tuberosity Round ligament of the head of the femur Femoral Epicondyles Lateral Malleolus Shaft Fovea Capitis Lesser sciatic notch Sustentaculum tali Neck of Femur Linea Aspera Talus Gerdy’s tubercle Lunate surface Tarsus Medial / Lateral Tibial Condyles Tibial tuberosity Medial Malleolus Trochlear surface OSTEOLOGY: THE FOOT Structures in View: Calcaneus Talus Cuboid Navicular Cuneiform (Medial specific) Metatarsals (5th specific) Phalanges Calcaneus Structures in View: Sustentaculum Tali Calcaneal Tuberosity (Insertion of Achilles) Talus Structures in View: Head Neck Trochlear Surface (Not the spring) Metatarsals Structures in View: Head Shaft Base First Metatarsal Fifth Metatarsal Phalanges Structures in View: Proximal Distal Proximal Middle Distal Femur (anterior) Structures in View: Patellar Surface Medial Epicondyle Lateral Epicondyle Medial Condyle
    [Show full text]