Estimation of femoral neck anteversion in adults - A comparison between peroperative, clinical and biplane X-rays methods

Background: The accurate estimation of femoral neck anteversion in living subjects has always been difficult with lots of inter- and intra-method variations. The present study was undertaken to define the range of normal femoral neck anteversion in our adult population and to draw the relationship between the peroperative, biplane X-rays and clinical methods. Methods: Femoral neck anteversion was evaluated by the peroperative, biplane X-rays and clinical methods on 31 otherwise healthy and normal adults who underwent closed reduction / open reduction and internal fixation for post traumatic fresh intracapsular fracture of the neck of femur. Results: The mean value obtained by peroperative, biplane Xrays and clinical methods were 10.6° (n=31 hips), 11.7° (n=62 hips) and 13.0° (n=62 hips) respectively. No statistically significant difference was found between the sides and the sexes. The clinical method correlated better with the peroperative method than the X-rays method. Conclusion: The average femoral neck anteversion in our subjects was estimated to be 10.6° (SD 2.2°) by the per-operative method, with 83.6% subjects having anteversion between 8.612.6°. This is less than most of the western data. Statistical relations have also been drawn between the peroperative, X-ray and the clinical methods.