286

In the case when the femur is centered, if the C.M.I. is below 1, the femoral piece has to be cemented. If the C.M.I. is above 1, it is a good indication for the cementless implant: one has to calculate the F.F.I., to choose between a standard implant or a custom made implant. For an F.F.I. betw e e n 3 and 4.5, w e use a s t a n d a r d cementless implant; for a F.F.I. below 3 or above 4.5 we would rather use a custommade cementless implant. In the case when the femur is not centered, a r e c e n t e r i n g o s t e o t o m y often allows to ring a simple case. If an osteotomy is not possible, one has to discus the need for the made-to-measure compared to an under dimensioned cemented shaft.

M.H. Fessy et al.: Choice of the femoraI implant in the total hip arthroplasty

Conclusion

References

With or without cement, this is not the d e b a t e a n y m o r e . I f we o p t f o r the c e m e n t l e s s , one has to k n o w h o w to choose its indications so that one can optimise the results. From our experience, this c h o i c e rests on the C o r t i c o Medullary Index analysis, tree reflection of the bone metabolism. If the cementless implant is retained, the F e m o r a l Flare Index allows to choose between a standard implant eand a custom m a d e implant.

1.

2.

3.

4.

5.

Dorr LD, Macket AM (1991) Anatomical porous replacement hip system: The interface. Orthop Relat Sci 2:159-166 Fessy MH, Bejui J, Fischer LP, Bouchet A (1995) The upper end of the femur: Dimensions of the endosteal canal. Surg Radiol Anat 17:155-160 Noble PC, Alexander JW, Lindahl LJ, Yew DT, Granberry WM, Tullos HS (1988) The anatomic basis of femoral component design. Clin Orthop 235:148-165 Noble PC (1990) Proximal femoral geometry and the design of cementless hip replacements. Orthop Retat Sci t: 86-92 Rnbin PJ, Leyvraz PF, Heegaard JH (1989) Variations radiologiques des param~tres anatomiques du f~mur proximal en fonction de sa position en rotation. Rev Chir Orthop 75: 209-215

Received December 6, 1996 / Accepted in final form April 3, 1997

Surg Radiol Anat (1997) 19:286

Book review

Surgical Rad' ic Anatomy

Journal of Clinical Anatomy

© Springer-Verlag 1997

Atlas d'Embryologie Clinique Anatomie sectionnelle et imagerie de I'embryon et du f~etus M.-J. Wolff-Qnenot, H. Sick (1997) De Boeck Universit6. 344 p., 245 F

As well as being a traditional atlas, this book is also a true textbook giving complete and didactic information. The atlas presents the sectional anatomy of the embryo from the 4th to the 7th weeks of development and that of the fetus from the 8th to the 12th weeks. It consists of a total of 127 serial sections, alternately transverse and sagittal, for the progressive stages of growth. Each double page carries a microphotograph with a corresponding shaded drawing with legend, and a short text in an insert specifying the transformations marking the stage of development. The illustrative quality of the sections and their manner of succession give a strikingly effective account of the dynamics of embryonic development and the spatial arrangement of the organs in situ. An initial chapter reviewing the general evolution during the

first trimester of pregancy and a final chapter consisting of recapitulatory and comparative chronologic pictures complete this presentation of sectional anatomy. Designed to satisfy clinical and teaching needs, this book is also indispensable for prenatal diagnosis by modern imaging and therefore includes numerous correlations with ultrasound images. There can be no doubt that generations of students, teachers and clinicians will profit from the abundance of information contained in this text. Indeed, thanks to its truly original conception and its ease of consultation, this work at last renders embryology accessible to the greatest number.

J. *L. Dumas