Morphology of the Proximal Human Femur in Relation to Fractures of Trochanteric Massif

Abstract

AIM: Fractures of proximal end, especially fractures of trochanteric massif are very common particularly in old patients. The aim of the work was to try to find a morphological correlate of trochanteric fractures in the region of proximal end of the human femur. It means to find if a "locus minoris resistentiae" for trochanteric fractures origin exists. METHOD: The detailed overview of literature on femur as a bone, classification of trochanteric fractures and treatment of proximal end of the femur was accomplished (sources from medieval books to recent anatomical and clinical studies). Czech and Latin terminological aspect (Terminologia anatomica 1998) of the femur as well as their development were carefully studied. 40 femurs from embalmed bodies with muscles and ligaments were studied by detailed dissection. 99 X-ray pictures of pertrochanteric fractures were checked. 106 dry femurs from the vascular canal distribution point of view were evaluated and compared with previous group of X-rays. Statistic evaluation of normal distribution according to Kolmogorov-Smirnov's test and Liliefors's modification was made in 15 regions of trochanteric massif. 20 dry femurs according to Heřt, Fiala and Petrtýl's method were repeatedly ground to depict the central vascular canals and to describe the course of osteons..