PROXIMAL FEMORAL MORPHOMETRY OF ADULT NEPALESE POPULATION

MEDICINE

Background: The proximal femoral morphometry varies among different population according to age and differs in males and females. The management of many of the hip problems involves the restoration of near normal anatomy of the hip by application of prosthetic devices and implants. Currently proximal femoral implants are available in standard sizes in reference to western population and such implants therefore could have limitations when used to the diverse ethnicity of Nepalese population. A study of proximal femoral morphometry in Nepalese adult population would provide information to design implant for Nepalese population. Aims and Objectives: To study the dimensions of proximal femur of adult Nepalese population in radiographs. Materials and Methods: Cross Sectional study was carried out in Outpatient Department (OPD) and Emergency Department of Bir Hospital and National Trauma Center, Kathmandu in patient of age group 25 years and above. Patients fulfilling the inclusion criteria were ordered X-ray pelvis antero-posterior view including bilateral hip joint.  Parameters like HAL (Hip axis length), NAL (Neck axis length),HW (Head width),NW (Neck width),TW(Trochanteric-width),NSA (Neck Shaft Angle),NL(Neck Length) were considered and relationship between Height, Weight and BMI of the patients with the morphometric parameters was assessed. Results: The average age of the participants was 43.86 years (Range: 25 years – 80 years). Out of which 57.2% were males and 42.8% were females. There was predominance of Mongolians (24.1%) followed by Brahmins (22.8%) and chhetris (20%) in the study . The average values of proximal femoral morphometric parameters were found to be HAL:114.74 ± 10.46mm, NAL: 101.14 ± 8.95mm, HW: 49.06 ± 4.21mm, NW: 33.01± 4.44mm, TW: 59.79 ± 5.11mm , NSA: 123.58° ± 4.01° and NL 26.26 ± 3.81.These values were different from the previous studies done in cadaveric femora in Nepal and also from other population. Significant differences were found in HAL, NAL, HW, NW, and TW between male and female participants; however, there was no significant difference in NSA between the two categories. Height and weight had strong linear correlation with HAL, NAL, HW, NW, NL and TW but no significant correlation with NSA. There was statistically significant weak correlation of only HAL and NW with BMI. Conclusion: This study showed that the values of proximal femoral morphometric parameters differ from previous studies done in cadaveric femora in Nepal. Values also vary from the other population. NSA in particular was found to be much lower compared to the western population.

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