老人股骨颈骨折后髋关节软骨退变的病理学研究  

Pathologic study of degeneration of articular cartilage following femoral neck fractures in aged patients

作　　者：宋文锴[1] 裴福兴[1] 张贤良[2] 杨静[1] 杨天府[1] 

机构地区：[1]四川大学华西医院骨科,成都610041 [2]四川大学华西医院病理科,成都610041

出　　处：《中华创伤杂志》2002年第3期136-138,共3页Chinese Journal of Trauma

摘　　要：目的　研究股骨颈骨折后软骨退变的发生、发展与伤后时间的关系。　方法　对 6 0～ 89岁 2 2例新鲜、19例陈旧性股骨颈骨折患者及 8例新鲜尸体正常髋关节软骨进行病理检查及图像分析。　结果　老人股骨颈骨折后 3～ 4周 ,软骨开始退变 ,HE染色正常 ,而Ⅱ型胶原和蛋白多糖含量低。伤后超过 2个月 ,HE染色细胞和基质退变 ,Ⅱ型胶原免疫组化不着色。伤后超过 4个月 ,软骨细胞逐渐死亡 ,并不断发展至骨关节炎。　结论　老人股骨颈骨折后软骨退变 ,首先是Ⅱ型胶原与蛋白多糖丧失 ,2～ 4个月后发生光镜下细胞和基质退变。此时患者关节软骨严重退变 ,宜行全髋关节置换术。Objective To research the relationship between posttraumatic time and pathologic degeneration of the cartilage following femoral neck fractures in aged patients. Methods The articular cartilage of 22 fresh and 19 old displaced femoral neck fracture patients with age from 60-89 years and 8 control specimens were examined under microscope and measured by image analysis. Results Three-four weeks after femoral neck fractures in aged patients the cartilage began to degenerate, HE staining was normal, Type Ⅱ collagen and proteoglycans were lost without any morphologic changes. Two-four months later the articular cartilage degenerated greatly under light microscope and chondrocytes were lost to develop osteoarthritis. Conclusions In cartilage degeneration after femoral neck fractures in aged patients a loss of Type Ⅱ collagen and proteoglycan occurs first, 2-4 months later chondrocytes degenerate with morphologic change. So the aged patients with femoral neck fractures should be treated by total hip arthroplasty.

关 键 词：老人 股骨颈骨折 髋关节软骨退变 病理学 

分 类 号：R683.42[医药卫生—骨科学]