脆性股骨颈骨折的皮质骨变化  

The change of cortex in fragile fracture of femoral neck

作　　者：李毅中[1] 庄华烽[1] 林金矿[1] 李建龙[1] 姚学东[1] 俞海明[1] 

机构地区：[1]福建医科大学附属第二医院骨科,福建泉州362000

出　　处：《中国骨质疏松杂志》2011年第6期508-510,共3页Chinese Journal of Osteoporosis

摘　　要：目的研究脆性股骨颈骨折的股骨颈皮质骨变化及临床意义。方法对59例病人行股骨近端CT扫描,骨折组28例,年龄:74.4±9.3岁;男9例,女19例;非骨折组31例,年龄:64.1±9.2岁;男11例,女20例。取对侧(正常侧)股骨小转子顶点上方20 mm(T20)平面CT横截面影像,计算T20长径和股骨颈寛径皮质比率,计算公式为:T20长径皮质比率=T20长径-T20髓腔长径/T20长径×100%;股骨颈宽径皮质比率=股骨颈宽径-股骨颈髓腔宽径/股骨颈宽径×100%。结果 T20长径皮质比率:骨折组:18.02%±4.62%;非骨折组:23.38%±5.19%(P=0.000);T20股骨颈宽径皮质比率:骨折组:26.78%±4.90%;非骨折组:33.08%±5.93%(P=0.000)。提示脆性股骨颈骨折病人股骨颈皮质明显变薄。结论股骨颈皮质变薄是导致脆性股骨颈骨折重要因素,T20长径皮质比率和T20股骨颈宽径皮质比率是观察股骨颈皮质骨变化的有效指标。Objective To study the cortical change of femoral neck in fragile fracture of femoral neck and its clinical significance. Methods The proximal femur was examined with CT scan for 59 patients. There were 28 patients with fragile fracture of femoral neck in fracture group including 9 males and 19 females. The patients＇ age was 74.4 ± 9.3 yrs. There were 31 patients including 11 males and 20 females in non-fracture group. The patients＇ age was 64. 1 ± 9.2 yrs. The parameters were defined from the CT films at T20 level （the neck at 20 mm higher than the apex of lesser trochanter） in the contralateral （normal side ） hip. The cortex ratio was calculated. The cortex ratio of T20 long dimension = T20 long dimension -T20 long dimension of marrow cavity/T20 long dimension × 100%. The cortex ratio of wide dimension of neck at T20 = wide dimension of neck at T20 - wide dimension of neck cavity at T20/wide dimension of neck at T20 × 100%. Results The cortex ratio of T20 long dimension was 18.02% ± 4.62% in the fracture group and was 23.38% ±5. 19% in non-fracture group （P =0.000）. The cortex ratio of wide dimension of neck at T20 was 26. 78% ±4.90% in the fracture group and was 33.08% ±5.93% in non-fracture group （P =0. 000）. The results suggest that the thinning cortex of femoral neck is significant in the patients with fragile fracture of femoral neck. Conclusion The thinning cortex of neck was a main factor leading to fragile fracture of femoral neck. The cortex ratio of T20 long dimension and of wide dimension of neck at T20was effective for evaluating cortex change of femoral neck.

关 键 词：脆性骨折 股骨颈 皮质骨 

分 类 号：R683.42[医药卫生—骨科学]