老年股骨上段标本几何参数及骨密度与生物力学性能的相关性分析  

Biomechanical evaluation of the effect of femoral neck fracture about geometric factors and bone mineral density

作　　者：张扬[1] 雷伟[1] 吴子祥[1] 于良[2] 

机构地区：[1]第四军医大学西京医院全军骨科研究所,西安710032 [2]西安交通大学机械学院机械振动与结构强度国家重点实验室

出　　处：《中国骨质疏松杂志》2009年第1期32-35,共4页Chinese Journal of Osteoporosis

摘　　要：目的探讨股骨颈部几何因素及骨密度对髋部骨折的影响，通过生物力学试验研究髋部生物力学性能与二者的关系。方法随机选取16例甲醛浸泡国人成年男性尸体股骨上段标本，测量其几何参数（包括股骨颈长、股骨颈直径、股骨头直径及颈干角）和骨密度，再通过生物力学试验，比较各因素对股骨颈生物力学特性的影响。结果转子间骨密度、股骨颈骨密度及股骨头直径与股骨的生物力学特性有明显的相关性（r=0．792，r^2=0．628，P〈0．001；r=0．749，r^2=0．560，P=0．001；r=0．706，r^2=0．499，P=0．002）；逐步线性回归分析结果显示转子间骨密度、股骨头直径和股骨颈直径相结合是预测髋部骨折的最好方法（r^2=0．844，P〈0．001）。结论骨密度值结合股骨近端几何参数能提高对骨质疏松性髋部骨折的预测。Objective To evaluate the effect of hip fracture about geometric factors and bone mineral density and to explore the correlation between them by mechanical test. Methods： sixteen specimens of eadaveric human proximal femurs were selected randomly and measured their geometric factors （include neck axis length, neck diameter, head diameter and neck-shaft angle）and bone mineral density. Measure the forces at failure （N） to compare effect of these factors. Results： Significant correlation was shown between femur biomechanical properties and trochanter BMD, neck BMD and head diameter （r = 0.792, r^2 = 0.628, P 〈 0.001; r = 0.749, r^2 = 0.560, P = 0.001 and r = 0.706, r^2 = 0.499, P = 0.002）. Stepwise linear regression analysis showed that the best predictor of hip fracture was the combination of trochanter BMD, head diameter and neck diameter （r^2 = 0.844, P 〈 0.001）. Conclusions：The results confirm that the combination of BMD and upper femur geometry improve the assessment of the risk of osteoporotic hip fracture and that bone geometry plays an important role in the evaluation of bone strength.

关 键 词：骨质疏松 骨密度 几何参数 髋部骨折 

分 类 号：R683[医药卫生—骨科学]