Objective To further explore the morphological characteristics of tension bone trabeculae at the upper end of femur and "Ward triangle", so as to provide anatomical evidence for the pathogenesis and treatment of femoral neck fractures. Methods Forty femoral specimens (20 in normal group and 20 in osteoporosis group) were cut along the axial, coronal, cross-sectional, and sagittal planes of femoral neck respectively to observe the morphological characteristics of tension bone trabeculae, the cortex of femoral neck and "Ward triangle" in normal group and osteoporosis group. Results Some tension bone trabeculae originated from the subchondral bone on femoral head, ran in an arc forward, and merged with anterosuperior cortical bone of femoral neck. Another part of tension bone trabeculae originated from the cortical bone of femoral neck and connected to greater trochanter, the base of femoral neck, and the inner surface of the lateral cortical bone at the upper end of femur. In normal group, tension bone trabeculae were dense, and the anteromedial cortex of femoral neck was dense, with a thickness of (1.64±0.06) mm. In osteoporosis group, tension bone trabeculae were sparse, and the anteromedial cortex of femoral neck was loose, with a thickness of (1.20±0.04) mm (P<0.05). On the axial and coronal section of the upper end of femur, "Ward triangle" was shown in a rhombus shape. In normal group, the internal trabeculae were dense, while in osteoporosis group, "Ward triangle" area was large, with sparse trabeculae. The anteversion angle in osteoporosis group (8.78±1.07)° was significantly lower than that in normal group (13.78±1.92)°. Conclusions The anterosuperior cortical bone of femoral neck and the trabeculae attached to the inner surface together form tensile system at the upper end of femur. In osteoporosis group, both the trabeculae and cortical bone of this system become sparse, the cortical bone becomes thinner, Ward rhombic area becomes larger. This may be one of the anatomical factors for femoral neck fractures in osteoporosis. Protecting tension bone trabeculae is the key to preventing femoral neck fractures.
Key words
Tension bone trabeculae /
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Bone cortex /
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Ward triangle /
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Osteoporosis /
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Femoral neck fracture
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