Radiological Morphometry of the Proximal Femur in Kenyan Adult Patients at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Background: The prevalence of proximal femur and hip ailments is increasing, requiring appropriate treatments such as osteosynthesis and arthroplasty. Preoperative planning relies on morphometric dimensions of the proximal femur, yet anatomical variations across populations mean many commercial implants may not fit optimally. Selecting the correct implant is crucial to avoid postoperative complications, hence the need for this study. Objectives: To determine the radiomorphometric measurements of the neck-shaft angle (NSA) and femoral head diameter (FHD) in Kenyan adults at Moi Teaching and Referral Hospital (MTRH) to guide implant design and assess variations by gender, laterality, and influencing factors. Methods: A cross-sectional survey was done on 118 normal radiograph patients comprising of 57 (48.3%) males and 61 (51.7%) females. Student-t-test was used to compare the measurements of the proximal femur in relation to gender and laterality. Statistical significance was determined by a p-value less than 0.05. Continuous data was presented as mean, standard deviation, median, interquartile range, while categorical data as frequency and proportions. Results: Results reveal that, for factors affecting NSA and FHD, Age (p-value 0.911), Gender (p-value 0.643), Region (p-value 0.449) and Level of activity (p-value 0.498) did not have statistical significance on the findings while Diet (p-value 0.029) was statistically significant.  Majority of patents were of middle age. The mean Femoral NSA and FHD diameter in Kenyan adult patients varied from those of other populations. The mean NSA and FHD varied in relation to gender (males greater) and laterality (right greater, but difference not statistically significant) in terms of measurements. Diet factor finding was statistically significant. Conclusion and Recommendations: Implants should be designed according to the new measurements in this study. Orthopaedic Surgeons should always consider morphometric dimensions before osteosynthesis in the proximal femur and arthroplasty of the hip.