Study of Morphometric Collo-Diaphyseal Angle of Femur in Homozygous Sickle Cell Nigerian Children

Aims: The aim is to investigate the neck-shaft angle or Collo-Diaphyseal Angle (CDA) of femur and the effect of homozygous sickle cell (HbSS) on the angle.
Study Design: A retrospective study.
Place and Duration of Study: Radiology Departments of two Hospitals in Maiduguri, namely Umaru Shehu Modern Hospital and University of Maiduguri Teaching Hospital (UMTH), between January, 2009 - December, 2010.
Methodology: Using plain radiographs of the femur, a total of 194 HbSS and 40 control (non-HbSS) children below 17 years of age were selected. The study samples whose clinical data had been excluded from any diseases that could modify the femur were studied. The Technical Error of Measurement (TEM) was performed by the evaluator. Ethical clearance for the study was obtained from the relevant body of these government hospitals.
Results: The TEM values obtained were less than 1 and were considered as a good measurement method for the evaluator performance. The CDA (mean ± standard deviations) were higher in males than females. The CDA in the left femur was greater than the right both for males and females, respectively. Furthermore, the study documents, probably for the first time that in few cases there was a reduction in the CDA of HbSS when compared with the control groups. The study revealed that there was sexually significant variation (p<0.05). The demarking points and index of sexual dimorphism of CDA show sex differences and can be used for sex determination.
Conclusion: The results from this study reveal that the mean CDA of femur of HbSS children of the study population were sexually dimorphic. The information from this study may aid forensic pathologists, orthopaedic surgeons and future research in evaluation of the femur.