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Objective <p>To measure the key anatomical parameters of the proximal femur in healthy Chinese adolescents aged 10–19&#xa0;years, and to clarify the morphological differences in this population, so as to provide basic anatomical data and morphological references for surgical protocol formulation, prosthesis selection, and personalized implant design related to the proximal femur in adolescents.</p> Methods <p>A retrospective collection of anteroposterior pelvic X-ray data of normal adolescents aged 10–19&#xa0;years was conducted from 3 hospitals, with a total of 300 cases (600 sides) enrolled. Participants were stratified into 10 groups by sex and one-year age intervals, with 30 cases per group (15 males and 15 females). Six morphological parameters of the bilateral proximal femur were measured using Mimics 21.0 software, including femoral head epiphyseal height (FHEH), femoral head diameter (FHD), femoral neck width (FNW), femoral neck-shaft angle (NSA), femoral offset (FO), and medullary canal diameter at the midpoint of the lesser trochanter (MCD-LT). SPSS 27.0 software was applied for statistical analysis: independent-samples t-test was used to compare the differences between sexs, paired-samples t-test was adopted for side-to-side differences, Pearson correlation analysis was performed to evaluate the association between each parameter and age as well as the correlation among parameters, and intraclass correlation coefficient (ICC) test was utilized to assess the inter-observer and intra-observer measurement consistency.</p> Results <p>The inter-observer and intra-observer ICC values for proximal femoral anatomical measurements all exceeded 0.82, indicating good reliability. No significant side-to-side differences were observed for any measurement (P &gt; 0.05). Except for the intramedullary canal diameter at the midpoint of the lesser trochanter (P = 0.506), the other five measures showed significant sex differences (P &lt; 0.001). Each parameter was significantly correlated with age (P &lt; 0.001). The femoral neck-shaft angle was negatively correlated with age (r = − 0.681 in males, r =  − 0.506 in females), while the other five parameters were positively correlated with age. The strength of correlation with age was higher in males than in females. Most parameters were positively correlated in males (r = − 0.593 to 0.885), and the overall correlation among parameters was weaker in females (r = − 0.463 to 0.723).</p> Conclusion <p>The anatomical parameters of the proximal femur in Chinese adolescents aged 10–19&#xa0;years exhibit significant age‑ and sex‑related differences, with favorable bilateral symmetry. Prosthesis selection and individualized implant design for adolescent orthopedic surgery should take regional and ethnic differences into account.</p>

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Anatomical morphometric analysis of the proximal femur in adolescents aged 10–19 years: a multicenter retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月4日

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  • Wang Zhenyu,
  • Sun Ruifen,
  • Tian Bowen,
  • Li Jiawei,
  • Wang Haiyan,
  • Zhang Kai,
  • Zhao Anqiao,
  • Li Xiaohe

摘要

Objective

To measure the key anatomical parameters of the proximal femur in healthy Chinese adolescents aged 10–19 years, and to clarify the morphological differences in this population, so as to provide basic anatomical data and morphological references for surgical protocol formulation, prosthesis selection, and personalized implant design related to the proximal femur in adolescents.

Methods

A retrospective collection of anteroposterior pelvic X-ray data of normal adolescents aged 10–19 years was conducted from 3 hospitals, with a total of 300 cases (600 sides) enrolled. Participants were stratified into 10 groups by sex and one-year age intervals, with 30 cases per group (15 males and 15 females). Six morphological parameters of the bilateral proximal femur were measured using Mimics 21.0 software, including femoral head epiphyseal height (FHEH), femoral head diameter (FHD), femoral neck width (FNW), femoral neck-shaft angle (NSA), femoral offset (FO), and medullary canal diameter at the midpoint of the lesser trochanter (MCD-LT). SPSS 27.0 software was applied for statistical analysis: independent-samples t-test was used to compare the differences between sexs, paired-samples t-test was adopted for side-to-side differences, Pearson correlation analysis was performed to evaluate the association between each parameter and age as well as the correlation among parameters, and intraclass correlation coefficient (ICC) test was utilized to assess the inter-observer and intra-observer measurement consistency.

Results

The inter-observer and intra-observer ICC values for proximal femoral anatomical measurements all exceeded 0.82, indicating good reliability. No significant side-to-side differences were observed for any measurement (P > 0.05). Except for the intramedullary canal diameter at the midpoint of the lesser trochanter (P = 0.506), the other five measures showed significant sex differences (P < 0.001). Each parameter was significantly correlated with age (P < 0.001). The femoral neck-shaft angle was negatively correlated with age (r = − 0.681 in males, r =  − 0.506 in females), while the other five parameters were positively correlated with age. The strength of correlation with age was higher in males than in females. Most parameters were positively correlated in males (r = − 0.593 to 0.885), and the overall correlation among parameters was weaker in females (r = − 0.463 to 0.723).

Conclusion

The anatomical parameters of the proximal femur in Chinese adolescents aged 10–19 years exhibit significant age‑ and sex‑related differences, with favorable bilateral symmetry. Prosthesis selection and individualized implant design for adolescent orthopedic surgery should take regional and ethnic differences into account.