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Skeletal Radiology
Published in: Skeletal Radiology 1/2016

01-01-2016 | Scientific Article

Common site of subchondral insufficiency fractures of the femoral head based on three-dimensional magnetic resonance imaging

Authors: Kenyu Iwasaki, Takuaki Yamamoto, Goro Motomura, Kazuyuki Karasuyama, Kazuhiko Sonoda, Yusuke Kubo, Yukihide Iwamoto

Published in: Skeletal Radiology | Issue 1/2016

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Abstract

Objectives

The objective of this study was to investigate the common sites of subchondral insufficiency fractures of the femoral head (SIF) based on three-dimensional (3-D) reconstruction of MR images.

Materials and methods

In 33 hips of 31 consecutive patients diagnosed with SIF, 3-D reconstruction of the bone, fracture, and acetabular edge was performed using MR images. These 3-D images were used to measure the fractured areas and clarify the positional relationship between the fracture and degree of acetabular coverage.

Results

The fractured area in the anterior portion was significantly larger than in the posterior area. In 11 cases, the fractures contacted the acetabular edge and were distributed on the lateral portion. The indices of acetabular coverage (center-edge angle and acetabular head index) in these cases were less than the normal range. In the remaining 22 cases, the fractures were apart from the acetabular edge and distributed on the mediolateral centerline of the femoral head. The majority of these cases had normal acetabular coverage.

Conclusions

The common site of SIF is the anterior portion. In addition, two types of SIF are proposed: (1) Lateral type: the contact stress between the acetabular edge and lateral portion of the femoral head causes SIF based on the insufficient acetabular coverage, and (2) Central type: the contact stress between the acetabular surface and the mediolateral center of the femoral head causes SIF independent from the insufficiency of acetabular coverage. These findings may be useful for considering the treatment and prevention of SIF.
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Metadata
Title
Common site of subchondral insufficiency fractures of the femoral head based on three-dimensional magnetic resonance imaging
Authors
Kenyu Iwasaki
Takuaki Yamamoto
Goro Motomura
Kazuyuki Karasuyama
Kazuhiko Sonoda
Yusuke Kubo
Yukihide Iwamoto
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 1/2016
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-015-2258-6

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