Determination and significance of femoral neck anteversion
Determination and significance of femoral neck anteversion
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DOI：
10.1093/ptj/84.6.550
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发表时间：
2004-06-01
期刊：
影响因子：
3.2
通讯作者：
Cibulka, MT
中科院分区：
文献类型：
--
作者：
Cibulka, MT
股骨颈前倾(FNA)描述股骨的正常扭转或扭转。股骨颈前倾角被定义为假想的横线与穿过股骨头和颈中心的假想横线之间的夹角。(图1)(.1，2)在没有病理的成年人中，股骨扭曲，因此股骨的头和颈与身体的额面成15到20度的角度向前倾斜。(1，2)在某些情况下，FNA角度向前或向后指向远远超过这个角度。一些研究人员(3-8人)认为，FNA角度超出15到20度的平均角度是导致物理治疗师常见的许多不同的下肢骨科问题的一个因素。这次更新的目的是描述FNA如何与髋关节旋转有关，如何使用髋关节旋转的运动范围来预测FNA异常，以及如何利用髋关节旋转的不对称性来识别哪些患者可能有可能出现髋部和下肢的各种矫形问题。女性颈部前倾有时被称为“股骨内侧扭转”。(2，3)它被认为是由于宫内生活早期肢体的内侧(内)旋转造成的。(3)在出生后的发育过程中，FNA角度的减少通常发生在新生儿的生长过程中。FNA角平均为31度。(2)5岁时FNA角平均为26度，9岁时为21度，16岁时为15度。(2)FNA角每年减小约1.5度，直到约15岁。男性略小(小于15度)，女性略多(18度)(图1)。(2，4)股骨颈前倾角通常从左侧对称到右侧。(5)与FNA相反，当股骨头和颈部的角度小于FNA沿身体前平面的平均角度(15度-20度)时，股骨颈后倾(图1)。(6，7)在某些情况下，股骨头和颈部甚至可能从身体的额面向后倾斜。
Femoral neck anteversion (FNA) describes the normal torsion or twist present in the femur. Femoral neck anteversion is defined as the angle between an imaginary transverse line that runs medially to laterally,through the knee Joint and an imaginary transverse line passing through the center of the femoral head and neck (Fig. 1)(.1,2) In adults without pathology, the femur is twisted so the head and neck of the femur are angled forward between 15 and 20 degrees from the frontal plane of the body.(1,2) In some instances, the FNA angle is directed forward or backward well beyond this angle. Some researchers(3-8) suggest that FNA angles outside this 15- to 20-degree average are a contributing factor in many different orthopedic problems in the lower extremity that are commonly seen by physical therapists. The purpose of this Update is to describe how FNA is related to hip rotation, how hip rotation range of motion can be used to predict abnormal FNA, and how asymmetries in hip rotation may be used to identify patients who may be at risk for developing various orthopedic problems in the hip and lower extremity.Femoral neck anteversion sometimes is called "medial femoral torsion."(2,3) It is thought to result from medial (internal) rotation of the limb bud in early intrauterine life.(3) In postnatal development, a reduction of the FNA angle usually occurs during growth.(2,3) In the newborn, the average FNA angle is 31 degrees.(2) The average FNA angle is 26 degrees by 5 years of age, 21 degrees by 9 years of age, and 15 degrees by 16 years of age.(2) The FNA angle, therefore, diminishes about 1.5 degrees a year until about 15 years of age.2 In the adult, average femoral head and neck torsion forward of the body's frontal plane is about 15 degrees, a little less in men (less than 15degrees) and a little more in women (18degrees) (Fig. 1).(2,4) Femoral neck anteversion angle is typically symmetrical from the left side to the right side.(5)In contrast to FNA, femoral neck retroversion is present when the head and neck of the femur are angled less than the average FNA angle (15degrees-20degrees) along the frontal plane of the body (Fig. 1).(6,7) In some cases, the femoral head and neck may even be angled backward from the frontal plane of the body.