• femoral anatomy
• femoral neck-shaft angle
• hip biomechanics
• osteological measurement
• radiological measurement

• Artificial intelligence
• Deep-learning
• Hip dysplasia
• Lateral center edge angle
• Patient reported outcome measures
• Radiographs

• EOS
• femoral bowing
• knee flexion angle
• sagittal imbalance

• Ministry of Science and Technology, Taiwan
• National Cheng Kung University
• National Cheng Kung University Hospital

• Femoral neck fractures
• Femoral neck shaft angle
• Fracture
• NSA
• Neck shaft angle
• Proximal femur
• Radiographs

• signs and symptoms
• anatomy
• musculoskeletal system

• age
• gender
• hip
• joint side
• morphology

• cerebral palsy
• femoral head deformity
• hip dislocation
• hip reconstruction
• non-ambulatory

• Femur geometry
• body mass index
• fracture
• neck-shaft angle

As one of the leading causes of elderly patients’ hospitalisation, proximal femur fractures (PFFs) will present an increasing socioeconomic problem in the near future. This is a result of the demographic change that is expressed by the increasing proportion of elderly people in society. Peri-operative management must be handled attentively to avoid complications and decrease mortality rates. To deal with the exceptional needs of the elderly, the development of orthogeriatric centres to support orthogeriatric co-management is mandatory. Adequate pain medication, balanced fluid management, delirium prevention and the operative treatment choice based on comorbidities, individual demands and biological rather than chronological age, all deserve particular attention to improve patients’ outcomes. The operative management of intertrochanteric and subtrochanteric fractures favours intramedullary nailing. For femoral neck fractures, the Garden classification is used to differentiate between non-displaced and displaced fractures. Osteosynthesis is suitable for biologically young patients with non-dislocated fractures, whereas total hip arthroplasty and hemiarthroplasty are the main options for biologically old patients and displaced fractures. In bedridden patients, osteosynthesis might be an option to establish transferability from bed to chair and the restroom. Postoperatively, the patients benefit from early mobilisation and early geriatric care. During the COVID-19 pandemic, prolonged time until surgery and thus an increased rate of complications took a toll on frail patients with PFFs. This review aims to offer surgical guidelines for the treatment of PFFs in the elderly with a focus on pitfalls and challenges particularly relevant to frail patients.

• Delirium prevention
• Frailty
• Garden classification
• Surgical management

• 3D CT
• 3D MRI
• Femoroacetabular impingement

• Adolescent
• Adult
• Female
• Femoracetabular Impingement/diagnostic imaging
• Femoracetabular Impingement/pathology
• Humans
• Image Interpretation, Computer-Assisted
• Imaging, Three-Dimensional/methods
• Magnetic Resonance Imaging/methods
• Male
• Middle Aged
• Radiation Dosage
• Retrospective Studies
• Tomography, X-Ray Computed/methods

The position of the fovea of the femoral head is usually considered to be inferior or inferoposterior, despite the fact that few detailed anatomical studies have been performed. This study was performed to assess the position of the fovea in computed tomography and its correlation with standard radiographic measures of the proximal femur.

Computed tomography scans of the hip of 107 patients (54 women and 53 men) were evaluated. The semi-coronal and transverse views were used to assess the femoral neck–shaft angle and the neck version, as well as the size and position of the fovea in relation with the femoral neck axis and the size of the head.

The fovea was always located inferior to the neck axis in the semi-coronal plane. In the transverse plane, the fovea was always slightly posterior to the femoral neck axis, as approximately ¾ of its diameter was posterior to the axis. The position was unrelated to the neck–shaft axis and the neck–trochanter minor angle. There were no differences in the position between men and women; however, in women, the fovea is slightly larger than in men when related to the femoral head size.

The femoral neck axis in the transverse plane always crosses the anterior aspect of the fovea. Its position is unrelated to the angular geometry of the proximal femur, but related to the femoral head size. It is found to be relatively larger in women.

• Computed tomography
• Femur
• Fovea
• Hip

• Adolescent
• Adult
• Female
• Femur Head/anatomy & histology
• Femur Head/diagnostic imaging
• Hip Joint/anatomy & histology
• Hip Joint/diagnostic imaging
• Humans
• Male
• Middle Aged
• Tomography, X-Ray Computed

To find factors affecting hip and femoral deformities in children with spastic cerebral palsy (CP) by comparing various clinical findings with imaging studies including plain radiography and computed tomography (CT) imaging.

Medical records of 709 children with spastic CP who underwent thorough baseline physical examination and functional assessment between 2 to 6 years old were retrospectively reviewed. Fifty-seven children (31 boys and 26 girls) who had both plain radiography of the hip and three-dimensional CT of the lower extremities at least 5 years after baseline examination were included in this study.

The mean age at physical examination was 3.6 years (SD=1.6; range, 2–5.2 years) and the duration of follow-up imaging after baseline examination was 68.4 months (SD=22.0; range, 60–124 months). The migration percentage correlated with motor impairment and the severity of hip adductor spasticity (R1 angle of hip abduction with knee flexion). The femoral neck and shaft angle correlated with the ambulation ability and severity of hip adductor spasticity (R1 and R2 angles of hip abduction with both knee flexion and extension).

Hip subluxation and coxa valga deformity correlated with both dynamic spasticity and shortening of hip adductor muscles. However, we found no correlation between femoral deformities such as femoral anteversion, coxa valga, and hip subluxation.

• Bone anteversion
• Cerebral palsy
• Coxa valga
• Hip dislocation
• Muscle spasticity