Anthropometry of the proximal femur and femoral head in children/adolescents using three-dimensional computed tomography-based measurements

Abstract

Purpose: Defining normal anthropometric ranges of proximal femur and femoral head for each age group in children/adolescents is a necessity when differentiating normal anatomical variants from pathological deformities. Aim of this study is to define a set of normal anthropometric parameters based on 3D-CT measurements in normal asymptomatic children/adolescents and analyse the variations arising depending on age, side, and/or gender. Methods: Morphology of the proximal femur was retrospectively assessed in 170 hips (85 children, < 15 years). Measurements included covered femoral head volume (CFHV), femoral head diameter (FHD), femoral head extrusion index (FHEI), coronal alpha angle (CAA), lateral centre-edge angle (LCEA), anterior (AOS) and posterior head-neck offset (POS) and femoral neck-shaft angle (FNSA). Correlation analyses as well as inter- and intra-rater reliability were performed. Results: CFHV, LCEA, FHD and AOS/POS increased with age and FHEI, CAA, and FNSA decreased with age. None of the measurements correlated with the side. AOS showed a poor correlation with gender. Rapid growth phases were observed at the age of 1, 7 and 11. The inter- and intra-rater reliability was high (range ICC 0.8–0.99 Cronbach alpha 0.86–0.99). Conclusion: This data delivers a description of growth phases as well as gender and age-correlated reference values of the proximal femoral morphology that could be used by paediatricians and orthopaedic/paediatric surgeons to early diagnose proximal femur deformities and provide guidance in the planning of possible operations.