Int J Anat Res 2015, 3(2):1011-14. ISSN 2321-4287 1011

Original Article

THIRD TROCANTER OF HUMAN FEMORA IN NORTH KARNATAKAREGIONSarita Sylvia 1, Md.Khaleel Ahmed 2, Priyanka Jainapur 3.

ABSTRACT

Address for Correspondence: Dr. Md.Khaleel Ahmed, Assistant Professor, Department of Anatomy,KBNIMS, Kalaburagi. Karnataka, India. E-Mail: dr.mohammedkhaleel786@gmail.com

1 Associate Professor, Department of Anatomy, MRMC, Kalaburagi, Karnataka, India.*2 Assistant Professor, Department of Anatomy, KBNIMS, Kalaburagi. Karnataka, India.3 Post graduate, Department of Anatomy MRMC, Kalaburagi, Karnataka, India.

Introduction: In orthopaedic surgery, trochanteric region is an important as it’s an entry point, usually lateralside of the great trochanter, although anterior and posterior approaches have variable interest. For implantssuch as plates and DHS (dynamic hip screw), lateral approach is standard. After skin, fat tissue and fascia lata,vastuslateralis muscle is reached and elevated to approach lateral surface of subtrochanteric area. For implantsas intra-medullar nail, minimally invasive approach is in routine use. Despite abundant research of generalfemoral morphology, especially its specific morphological parts (femoral head, neck, shaft, and its distal partinvolved in knee joint).Materials and methods: Study on 158 dry adult human femur of unknown age & sex collected from the departmentof anatomy and phase I students of KBNIMS, Kalaburagi, Karnataka. The broken or non-dried specimens wereexcluded from the study.Results: The third trochanter was present in 4.43% of the femora. Although the incidence was higher on the rightside it was not statistically significant.Discussion: Another study which reported the side variations in Whites and Negroes, documented higher incidenceon right side in White and on left side in Negro population; it also reported the trait to be more common infemales in both Whites and Negroes.Conclusion: The presence of third trochanter at the proximal part of the femur has been found to alter the breaklines in the pertrochanteric fracture patients. This study dealt with the incidence of third trochanter in northKarnataka region.KEY WORDS: Third Trochanter, Gluteal Tuberosity, Proximal End Femur.

INTRODUCTION

International Journal of Anatomy and Research,Int J Anat Res 2015, Vol 3(2):1011-14. ISSN 2321- 4287

DOI: http://dx.doi.org/10.16965/ijar.2015.149

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Received: 26 Mar 2015 Accepted: 16 Apr 2015Peer Review: 26 Mar 2015 Published (O): 30 Apr 2015Revised: None Published (P): 30 June 2015

International Journal of Anatomy and ResearchISSN 2321-4287

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DOI: 10.16965/ijar.2015.149

The third trochanter may perhaps serve toincrease attachment surface area for thegluteal musculature thereby providing greaterefficiency of contraction. Gluteus maximusfunction may exert a mechanical loading on thethird trochanter thereby altering surfacemorphology. The presence of bony crests, ridges

and tuberosities are directly correlated to thefunction of contiguous muscle activity [1]. Inanthropometric studies on various populationsthe third trochanter is the commonly used non-metric variation in the post-cranial skeleton [2].Apart from anthropometric, comparative andfunctional studies, the third trochanter is a struc-ture of minor importance in humans.

Int J Anat Res 2015, 3(2):1011-14. ISSN 2321-4287 1012

Sarita Sylvia, Md.Khaleel Ahmed, Priyanka Jainapur. THIRD TROCANTER OF HUMAN FEMORA IN NORTH KARNATAKA REGION.

MATERIALS AND METHODS

The clinical significance of this structure as theinsertion of the gluteus maximus muscle issimilar to that of the gluteal tuberosity of thefemur, the iliotibial tract of the fascia lata andthe lateral femoral intermuscular septum.However, in some species of laboratorymammals the third trochanter plays animportant role as a useful landmark for biome-chanical studies and densitometry and as theaccess point of choice for the medullar cavity[3,4,5]. The correlation between muscle inser-tions and topography of break lines inpertrochanteric fractures of the proximal femurhas been recently discussed. A studysuggestedthat bone covered only with periosteum with noreinforcing elements of the attachments ofmuscles and ligaments, represent minorresistance for onset of fractures. Variability inthe sizes and shapes of pertrochanteric fracturefragments depend on variability of the locationsand sizes of soft tissue attachment areas atspecified sites on the proximal femur [6]. Inmany anthropometric studies the thirdtrochanter and the hypotrochantericfossa arecommonly used non metric variations of thepostcranial skeleton. They serve for descriptivepurposes of the proximal end of the femur invarious ethnic groups. The third trochanterfunctions to provide an attachment area for theascending tendon of the gluteus maximus. Thisskeletal variant, when present, occurs as anoblong, rounded or conical, roughened orsmoothened bony elevation which may becontinuous with the gluteal ridge and ismanifested as a distinct femoral entity [7]. Thestrong entheseal development in the femoralattachment of the gluteus maximus suggeststrong mechanical effort of the joint inextension, lateral stabilization and control of thethigh indicating medio-lateral reinforcement toresist high mechanical stress in erect postureand locomotion [8].

A study on 158 dry adult human femur ofunknown age & sex collected from thedepartment of anatomy and phase I students ofKBNIMS, Kalaburagi, Karnataka. The study wasdone over a period of 8 months (July to Febuary2015). All the femur were examined carefully

for any variations by visual inspection.Appropriate measurements were taken andspecimen was photographed. The clinicalimportance due to variations are discussed. Thebroken or non-dried specimens were excludedfrom the study.

RESULTS

The third trochanter was present in 4.43% ofthe femora. Although the incidence was higheron the right side it was not statisticallysignificant.The Hypotrochantericfossae is absent.

Fig. 1: Showing third trochanter of femur.

Third trochanter

Fig. 2: Showing right side third trochanter of femur.

Right side third trochanter

Fig. 3: Showing left side third trochanter of femur.

Left side third trochanter

Int J Anat Res 2015, 3(2):1011-14. ISSN 2321-4287 1013

Sarita Sylvia, Md.Khaleel Ahmed, Priyanka Jainapur. THIRD TROCANTER OF HUMAN FEMORA IN NORTH KARNATAKA REGION.

Table 1: Occurrence of the third trochannter.

Right Left

Third trochanter 4 3 4.43%Hypotrochatric

fossa _ _ Absent

TraitNumber of femur

Incidence

DISCUSSION

The incidence of the third trochanter in our studyis 4.43% with right sided predominance. A studydone on excavated femora from Poland whichshowed anincidence of 6.2%. However they didnot take any gender or side variations intoconsideration [9]. Another study which reportedthe side variations in Whites and Negroes,documented higher incidence on right side inWhite and on left side in Negro population; italso reported the trait to be more common infemales in both Whites and Negroes [10]. Thephenotypic development and expressiondiscontinuous skeletal traits were originallyconsidered to be controlled by genetic factors[11].Recent researches indicate the significance ofvarious biological and environmental factorssuch as age, sex, nutritional status or sidedependence influencing the manifestation ofcertain non metrictraits in non human andhuman populations [12,13,14]. Expression of thethird trochanter may be affected by mechanicalstress exerted by the gluteus maximus; thismuscle functions to decrease limb speed duringthe lateswing and heel strike phases oflocomotion. The third trochanter may perhapsserve to increase attachment surface area forthe gluteal musculature thereby providinggreater efficiency of contraction. Gluteusmaximus function may exert a mechanicalloading on the third trochanter thereby alteringsurface morphology. The presence of bonycrests, ridges and tuberosities are directlycorrelated to the function of contiguous muscleactivity [1]. The fossa hypotrochanterica is afossa, groove or pit at the site of insertion ofGluteus Maximus on the femur. The presence ofgluteal ridge, third trochanter or fossahypotrochanterica are all associated withGluteus maximus insertion in Man. In Gorilla,Chimpanzee and Orangutan, fossa hypo-trochanterica is found at this muscle attachment

whereas in Gibbons a gluteal ridge is found [14].

CONCLUSION

The incidence of the third trochanter in thefemora analysed was 4.43%.The third trochanterwas not correlated with any morphologicalfeature of the femoral head, neck and shaft.Thethird trochanter was correlated with transverseflattening of the superior end of the femur.The results of the study suggest that the thirdtrochanter is a structure which is correlated withan altered gluteal muscle function.Theknowledge of the occurrence would be crucialfor the diagnosis and management ofpertrochanteric fractures and also in the studyof microevolutionary trends in theanthropometric and comparative studies ofhumans.The presence of third trochanter at theproximal part of the femur has been found toalter the break lines in the pertrochantericfracture patients. This study dealt with theincidence of third trochanter in north Karnatakaregion.

Conflicts of Interests: None

REFERENCES

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How to cite this article:Sarita Sylvia, Md.Khaleel Ahmed, Priyanka Jainapur. THIRDTROCANTER OF HUMAN FEMORA IN NORTH KARNATAKAREGION. Int J Anat Res 2015;3(2):1011-1014. DOI: 10.16965/ijar.2015.149