Objective: To measure the displacement parameters of femoral head in space through three-dimensional reconstruction so as to reunderstand undisplaced femoral neck fractures.
Methods: The clinical data of 80 undisplaced femoral neck fractures from January 2010 to June 2011 were selected, included Garden I 40 cases (group Garden I) and Garden II 40 cases (group Garden II), bilateral proximal femurs of everyone were scanned by CT and reconstructed by professional software. Registered the normal femur and fracture with mirror model, marked key points in the model and measured the displacement parameters of femoral head. The measurement accuracy of distance and angle were 0.01 mm and 0.01°, respectively. The parameters of femoral head displacement between group Garden I and Garden II were analyzed by independent-sample t-test.
Results: Eighty cases on X-ray films were not found rotated displacement. But 24 cases of them (30.0%) showed rotated displacement and rotation direction of the femoral head through three-dimensional reconstruction. Ten cases showed incomplete fractures on X-ray films, but only 3 cases were incomplete fractures with three-dimensional reconstruction. In group Garden I, the femoral head displacement angle was 18° ± 11°, the average displacement distance of femoral head center and deepest point of fovea capitis were (6 ± 3) mm and (10 ± 6) mm respectively. In group Garden II, the femoral head displacement angle was 17° ± 10°, the average displacement distance of femoral head center and deepest point of fovea capitis were (7 ± 5) mm and (13 ± 8) mm respectively. There were not statistical significance of the parameters of femoral head displacement between group Garden I and Garden II (P > 0.05).
Conclusions: Three-dimensional reconstruction and digital measurement is a precise, efficient method for the measurement of femoral head displacement parameters in femoral neck fractures, has important clinical significance in the diagnosis and treatment of the femoral neck fractures. There are certain defects and limitations of the classical Garden classification for undisplaced femoral neck fractures.