3D Mapping of Bone Channel of Blood Supply to Femoral Head in Proximal Femur

Frontiers in Surgery

article

Shenghui Wu¹  Kun Quan²  Wei Wang³  Yingqi Zhang⁴  Jiong Mei¹ 

[1] Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital;Department of Orthopaedic Surgery, The First Affiliated Hospital of Nanchang University;Department of Biomedical Engineering, The Hong Kong Polytechnic University;Department of Orthopedic Surgery, Tongji Hospital, Tongji University School of Medicine

关键词: nutrient foramina;    mapping;    hip surgery;    three dimension (3D);    distribution;   

DOI  :  10.3389/fsurg.2022.852653

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background A detailed depiction of nutrient foramina is useful for defining guidelines and minimising iatrogenic damage during hip surgery. Therefore, this study aimed to define the location and frequency of nutrient foramina in the proximal femur using mapping techniques. Methods One hundred dry human cadaveric proximal femurs, comprising 56 left and 44 right femurs, were scanned using a three-dimensional scanner, with scanning distance 200 mm, precision 0.01 mm, and measuring point 0.04 mm. The image resolution of 1,310,000 pixels was obtained. Digital imaging models were acquired from the proximal femur surface. All the nutrient foramina in each model were identified and marked. The nutrient foramina models were superimposed on one another and oriented to fit a standard template of the femur’s proximal aspect. Three-dimensional mapping in the proximal femur’s nutrient foramina was performed. Results The nutrient foramina’s location and dense zones were identified. The dense zones were distributed along the vascular course and gaps between the muscle attachment sites. Eighteen dense zones were identified and found to be location-dependent. They were located in the central part of the fovea capitis femoris, subcapital and basicervical areas of the femoral neck, and muscle attachment gaps of the femoral trochanter. Conclusions The terminal branch of the nutrient vessels entering the nutrient foramina is at risk for iatrogenic damage during hip surgeries, especially in cases of close bone exposures. There are 18 dense zones that need to be considered for a safer approach to the proximal femur. To minimise iatrogenic damage to the nutrient vessels entering the nutrient foramina, the dense areas should be avoided when technically possible.

【 授权许可】

CC BY