Angle of torsion of the femur and its correlates

Abstract

Unpaired femora (171), devoid of gross pathology and grouped by gender (94 male and 77 female) and side (88 left and 83 right), were used to measure the angle of femoral torsion and the maximum femur length and to score the degree of prominency of the superior cervical tubercle, intertrochanteric line, quadrate tubercle, linea aspera, and adductor tubercle. The angle of torsion ranged from -9 to +35 degrees with a mean of +12.3 degrees. The means were not significantly different either by gender or side. The angle correlated negatively with superior cervical tubercle, intertrochanteric line, and adductor tubercle (P < 0.001), positively with quadrate tubercle (P < 0.001) but not with linea aspera, neck-shaft angle, or length of femur. Bony prominences were significantly more apparent in males. There was no significant association between prominency and side. The torsion seems to be brought about by muscular activity and capsular and ligamentous strain at the hip. This study suggests to clinicians the possibility of correction of torsion defects in certain hip diseases of growing children by suitable alteration in posture of the lower extremity.

Differences in Lower Extremity Anatomical and Postural Characteristics in Males and Females Between Maturation Groups

“…S ex differences in anatomical characteristics and lower extremity alignment continue to be cited as a potential risk factor for the increase prevalence of knee injury in females. 26 In the adult population, sex differences have been identified in the structures of the hips and knees, with females having greater anterior pelvic tilt, 29,54 femoral anteversion, 10,54,60 tibiofemoral angle, 33,54 quadriceps angle, 1,29,33,54,85 and genu recurvatum. 54,80 Conversely, no sex differences have been observed in measures of tibial torsion 54,56,76 and foot pronation as measured by navicular drop 29,51,54,80 and rearfoot angle.…”

“…Our data for MatGrp 2 (mean SD, 14.1° 5.9°; range, 6°-30°) are in line with those reported for 13 to 16 year olds in 2 of these studies (means ranging from 8° to 20°), 21,82 and our values in MatGrp 3 (10.9° 5.0°; range, -2.2°-21°) appear to be consistent with those obtained in healthy adult males and females (means ranging from 7° to 18°) using both clinical and imaging measurement methods. 10,38,54,60,61,66,68 However, our values for MatGrp 1 are substantially lower than those reported elsewhere. 21,78,82 Although using 2 testers introduces the potential for systematic differences between testers, 71 each tester measured subjects in all maturation groups; so it is unlikely that systematic measurement error alone explains these disparate findings.…”

Sex Differences in Clinical Measures of Lower Extremity Alignment

“…13,48,79 Our mean hip anteversion values are within the range of normal values reported in healthy adults (7°-18°), as measured by both clinical and diagnostic methods. 8,36,63,65,71,72 Our findings of greater hip anteversion in females as compared to males agree with those of other studies 8,63 ; but the magnitude of the sex difference is much larger in the current study (approximately 9° versus 2°-4°). This disparity may be explained by differences in measurement methods, as the previous studies report measures on cadavers or with ultrasound and the current study used clinical measures in healthy subjects.…”

Femoral Offset and its Relationship to Femoral Neck-shaft Angle and Torsion Angle

“…The results indicated that there were significant differences for FO not only between the male and female but also between the right and left, and this should be considered when planning THA. Prasad et al (1996) measured the femoral torsion angle in unpaired femurs (n=171), and found that the angle ranged from -9 to +35° with a mean of +12.3°, and was not correlated with the linea aspera, neck-shaft angle, or femoral length. Computed tomography was considered the method of choice for detecting the femoral torsion angle.…”