Assessment of the Femoral Neck-shaft Angles of Adults in Nigeria: Establishing an Age and Gender Stratified Reference Values

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Emmanuel C. Iyidobi
Bernard O. Obande
Gabriel O. Eyichukwu
Cajetan U. Nwadinigwe
Remigus T. Ekwunife
Osita Ede
Omolade A. Lasebikan


Background: The femoral neck-shaft angle (FNSA) has essential roles in the diagnosis of hip pathologies such as femoral neck fractures, developmental dysplasia of the hip and coxa vara and in the templating of implants and prosthesis for surgical fixation of femoral neck fractures and arthroplasties for hip pathologies. Most studies on the FNSA were done in western countries, and current hip implants in use are based on these studies. Since anthropometric measurements differ among races, it is possible that the FNSA might be different in Africans compared to the Caucasians.

Aim: This study aims to establish normal FNSA for adults in Nigeria stratified by age and gender.

Methods: This work was a cross-sectional study. We examined the pelvic x-rays of 75 patients, 30 males and 45 females, with no hip pathology. We also collected relevant biodata such as age, gender, weight and height. The ages of the subjects were categorized in a 10-year grouping from 20 to 99 years. The body mass index (BMI) was calculated for each participant and each subject was classified as normal weight, overweight or obese based on the BMI value. The FNSA was measured with a Goniometer both for the right and left side. The values of the FNSA was compared for both genders and the age categories. We also compared the mean FNSA for the right and left sides and assessed for significant differences in the FNSA among the groups of the body mass index.

Results: The mean age of the participants was 64 years ± 16.93 years. The mean FNSA was 131.04°± 3.86, with a range of 20° (120 – 140°). Males had a mean FNSA of 131.43° compared to females who had a mean FNSA of 130.78°, although the difference was not statistically significant. Also, no significant differences in the mean FNSA were seen concerning age categories, sides and BMI groups.

Conclusion: The mean FNSA of adults in this study is different from the western textbook value of 125°. This should be borne in mind when manufacturing hip implants and prostheses for domestic use.

Femur, neck-shaft angle, adults, Nigeria.

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How to Cite
Iyidobi, E. C., Obande, B. O., Eyichukwu, G. O., Nwadinigwe, C. U., Ekwunife, R. T., Ede, O., & Lasebikan, O. A. (2020). Assessment of the Femoral Neck-shaft Angles of Adults in Nigeria: Establishing an Age and Gender Stratified Reference Values. Asian Journal of Orthopaedic Research, 3(3), 1-7. Retrieved from
Original Research Article


Chummy SS. Last’s anatomy: Regional and applied. 12th Edition. UK, Elsevier Ltd. 2011;170.

Solomon L, Warwick D, Nayagam S. Apley’s systems of orthopedics and fractures. 9th ed, United Kingdom, Hodder Arnold, a Hachette UK Company. 2010; 843-859.

Morscher E. Development and clinical significance of the anteversion of the femoral neck. Reconstr. Surg. Traumat. 1967;9:107-125.

Houston CS, Zaleski WA. The shape of vertebral bodies and femoral necks in relation to the activity. Radiology 1967;89: 59-66.

Houston CS. The radiologist's opportunity to teach bone dynamics. Journal of the Association of Canadian Radiologists 1978;29:232-8.

Panula J. Surgically treated hip fracture in older people With Special Emphasis on Mortality Analysis, University of Turku, Turku, Finland [online]; 2010.

Amith R. Analysis of the ante version and neck shaft angle in dry femora of South Indians. Dissertation submitted to the Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore. 2012;5.

Anderson JY, Trinkaus E. Patterns of sexual, bilateral and interpopulational variation in human femoral neck-shaft angles J. Anat. 1998;192:279-85.

Adekoya-Cole TO, Akinmokun OI, Soyebi KO, Oguche OE. Femoral neck shaft angles: A radiological anthropometry study. Niger Postgrad Med J. 2016;23:17-20.

Nwoha PU. The Collodiaphyseal angle of the femur in adult Nigerians. Afr J Med Med Sci. 1991;20:143-7.

Tahir A, Hassan AW, Umar IM. A study of the Collodiaphyseal angle of the femur in the North-Eastern sub-region of Nigeria. Niger J Med. 2001;10:34-6.

Gilligan I, Chandraphak S, Mahakkanukrauh P. Femoral neck-shaft angle in humans: Variation relating to climate, clothing, lifestyle, sex, age and side. Journal of Anatomy. 2013;223(2): 133-151.

Yamaguchi O. A radiologic study of the hip joint in cerebral palsy. Journal of the Japanese Orthopaedic Association. 1993; 67:1-11.

Atkinson HD, Johal KS, Owen CW, Zadow S, Oakeshott RD. Differences in hip morphology between the sexes in patients undergoing hip resurfacing. Journal of Orthopaedic Surgery and Research. 2010; 5:76.

Rubin PJ, Leyvraz PF, Aubaniac LM, Argenson JN, Esteve P and de Rougin B. The morphology of the proximal femur. Journal of Bone and Joint Surgery. 1991; 74(B):28-32.

Lequesne M, Malghem J, Dion E. The normal hip joint space: Variations in width, shape and architecture on 223 pelvic radiographs. Ann Rheum Dis. 2004;63: 1145–51.

Liang J, Li K, Liao Q, Lei G, Hu Y, Zhu Y, et al. Anatomic data of the proximal femur and its clinical significance. J Cent South Univ (Med Sci). 2009;34(8):811-4.

Inam M, Satar A, Arif M, Shabir M. Proximal femoral geometry of Khyber Pakhtoonkhwa (KPK) population. The Journal of Pakistan Orthopaedic Association. 2011;23(2).

Harva TC, Meriheryavuz, MC. Comparison of femoral geometry among cases with and without hip fractures, Yonsei Medical Journal. 2004;45(5):901-907.

Panula J, savela M, Jaatinen PT, Aarnio P, Kivelä SI. The impact of proximal femur geometry on fracture type – A comparison between cervical and trochanteric fractures with two parameters. Scandinavian Journal of Surgery. 2008;97:266–271.

Akbar W, Kalimullah, Biomedica. A radiographic study of neck shaft angle in population of Mardan region, Khyber Pukhtonkhwa – Pakistan. Biomedica. 2015;31(2):108-114.

Jing G, Yia-wei S, Xiao S. Mechanical analysis and computer simulation of the structure of femoral neck [online]; 2006.
[Cited April 2014]