PubMed · 13035318
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
G A FRASER. 1953. Hearing after fenestration.. https://doi.org/10.1017/s002221510004857x
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Explore the source record for details and available documents.
OBJECTIVES: To determine whether flexion improves radiographic visualization of the femoral neck when the femur is externally rotated. METHODS: Five human femora, with varying neck-shaft and anteversion angles, were measured and immobilized. Degree of flexion required to bring the femoral neck horizontal was measured, varying the rotation. Next, one bone was radiographed in 16 positions, varying rotation in 15 degrees and flexion in 10 degrees increments. Radiographs were presented in randomized blinded fashion to 15 staff radiologists for scoring of femoral neck visualization. Following this, all 5 bones were radiographed in 4 positions of rotation and at 0 degree and 20 degrees flexion, and blinded randomized review of radiographs was repeated. Comparisons between angles and rotations were made using the Mann-Whitney test. RESULTS: The flexion angle required to bring the long axis of the femoral neck horizontal correlated directly with the degree of external rotation (p < 0.05). Visualization of the femoral neck in the extended position progressively deteriorated from 15 degrees internal rotation to 30 degrees external rotation (p < 0.01). However, when 20 degrees flexion was applied to bones in external rotation, visualization significantly improved at 15 degrees (p < 0.05) and 30 degrees (p < 0.01). CONCLUSION: Flexion of the externally rotated femur can bring the femoral neck into horizontal alignment, and a relatively small amount (20 degrees) of flexion can significantly improve radiographic visualization. This manoeuvre could be useful for radiography of the femoral neck when initial radiographs are inadequate because of external rotation of the leg.
Reconstruction using a free vascularized fibula was performed on a long bony defect after osteomyelitis of the proximal femur. For this type of bone defect, a double-barrel fibular graft is recommended. The authors used this procedure for a 58-year-old male who had osteomyelitis of the left proximal femur. As osteotomy through a transplanted fibula can be safely performed, abduction osteotomy should be considered when coxa vara remains after reconstruction with a free vascularized fibula transfer.