The nutrient artery canal of the femur: a radiological study in patients with primary total hip replacement.
OBJECTIVE
Plain antero-posterior and lateral radiographs of the femur often show radiolucent lines, which may reflect the canal of a nutrient artery. In patients who have undergone total hip replacement these radiolucent lines must be differentiated from fractures caused by bursting of the shaft during the procedure.


METHODS
In a retrospective radiological study 129 extremities of 95 patients with cementless primary hip prostheses were examined for radiolucent lines. Pre- and postoperative antero-posterior and lateral radiographs were analyzed.


RESULTS
In 34 of 129 extremities (26.4%) radiolucent lines compatible with a nutrient artery canal were detected, 14 of which (10.9% overall) were seen on lateral radiographs. In 11 of 129 extremities (8.5%) a nutrient artery canal was detected only on the antero-posterior views, while in 9 of 129 extremities (7.0%) it was well defined in both projections. One patient (0.8%) presented with a fracture postoperatively, which was radiologically distinct from a nutrient artery canal. The distance between the tip of the greater trochanter and the proximal end of the nutrient artery canal was 170+/-25 mm; the canal length was 27+/-9 mm.


CONCLUSIONS
Nutrient artery canals are often seen radiologically on pre- and postoperative radiographs down to the mid-shaft level and should be routinely recorded.
Schiessel
Andreas
A
Orthopädisches Krankenhaus Wien, Wielemansgasse 28, 1180 Vienna, Austria. schiessel@aon.at
Zweymüller
Karl
K
D000368:Aged; D001158:Arteries; D019644:Arthroplasty, Replacement, Hip; D003937:Diagnosis, Differential; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging; D005269:Femur / Q000098:blood supply* / Q000000981:diagnostic imaging*; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies