脆性股骨颈骨折的股骨近端几何结构分析

The analysis of proximal femur geometry in fragile fracture of femoral neck

目的研究脆性股骨颈骨折的股骨近端几何结构特点。方法将57例患者分为两组。骨折组29例,平均年龄73.6±9.9岁,性别:男10例,女19例;非骨折组28例,平均年龄64.8±9.3岁,性别:男10例,女18例。对患者股骨近端CT扫描的定位像进行健侧股骨近端几何结构参数测量。结果骨折组的股骨颈颈长较长、颈中段皮质厚度变薄、颈干角较大、颈中段皮质厚度比率下降、颈中段宽度与颈轴长比率下降、颈长与颈轴长比率升高、颈长与颈宽度比率升高,两组比较有统计学意义;颈轴长、颈中段宽度、颈中段髓腔宽度在两组比较中没有统计学意义。结论在脆性股骨颈骨折中,股骨近端几何结构的参数在其绝对数值上有着重要性,而股骨近端各部分结构在比率上的合理配置对股骨近端的骨强度也起着重要的作用。

Objective To study the characteristics of proximal femur geometry in fragile fracture of femoral neck. Methods The topviews of CT scan in the proximal femurs were collected for 57 patients. There were 29 patients with fragile fracture of femoral neck in fracture group including 10 males and 19 females（ mean age 73.6 ±9.9yrs, range 53-88yr）. There were 28 patients in non-fracture group including 10 males and 18 females（ mean age 64. 8 ±9. 3yrs, range 50-82yr）. The parameters of proximal femur geometry in the topviews of CT scan were measured with medical film reading software. Results There were statistically significant differences between the two groups with the longer femoral neck length（FNL） ,thinner cortical thickness of femoral neck（FNCT） ,greater femoral neck-shaft angle（NSA）,decreased ratio of FNCT/FNW, decreased ratio of FNW/FNAL, increased ratio of FNL/FNAL and increased ratio of FNL/FNW in the fracture group. There were no statistically significant differences in the measurements of the femoral neck axis length（FNAL） ,femoral neck width（FNW） and femoral medullary cavity width （FMCW） between the two groups. Conclusion The values of geometrical parameters in proximal are very important in fragile fracture of femoral neck and the rational ratios of each part in proximal femur also plays an important role in bone strength.