老年股骨颈形态与骨折类型的相关性分析

Analysis of the correlation between femoral neck morphology and fracture

目的通过对老年股骨颈长度与骨折的形态分析即股骨颈最小直径(AB)/AB中点垂直的股骨颈最大延长线(CD)的比值t的大小,进一步准确判断骨折类型,更加准确认定分型级别,为采用适合的治疗方案,提高骨折一次性治愈率提供依据。方法选择我院从2002年1月至2012年1月的268例非骨折病人作为对照组,检测CD与AB的比值,计算t系数,得出左右两侧数值及数值差;同时选择86例股骨颈骨折的对象作为病例组,测量健侧t系数,依据非骨折病人左右两侧t系数及其差值的大小进一步判断骨折类型。结果根据老年股骨颈长度与骨折的形态分析,结果显示:男性0.36≥t≥0.32,女性0.33≥t≥0.29多为GardenⅠ、Ⅱ型或头下型或基底型骨折;男性t<0.32或t>0.36,女性t<0.29或t>0.31多为GardenⅢ-Ⅳ型或颈中型,t系数分型在Garden分型及骨折部位分型基础上更加准确认定分型级别。结论根据老年股骨颈长度与骨折的形态分析在Garden分型及骨折部位分型基础上能更加准确认定分型级别,降低误诊、误治概率,增加骨折一次治愈的可能,进一步提高治愈率。

Objective To identify the classification level of fracture by the length and morphology of the femoral neck and to improve the cure rate. Methods 268 non-fracture people in our hospital from January 2002 to January 2012 were randomly chosen as the control group. The ratio of the femoral neck length CD and femoral neck diameter AB of control group was detected, t coefficient calculated, and the bilateral difference was analyzed. And 86 cases suffering from femoral neck fracture were chosen as the case group.The eontralateral t coefficient was measured, and their fracture types were con- firmed based on the difference of bilateral t coefficient. Results Male with 0. 36 I〉 t I〉 0. 32, female with 0. 33 ~〉 t i〉 0. 29 was Garden I , l] or under the head or the substrate species;Male with t〈O. 32 or t〉0. 36,female with t〈0. 29 or t〉0. 31 was Garden Ⅲ-IV or neck medium, in the Garden species. Classification of fracture types helped to decrease the misdiagnosis, mistreatment probability and further improve the cure rate. Conclusions Based on the analysis of the length and morphologic characteristics of the femoral neck fracture of the aged people, we can accurately classify the fracture types, decrease mistreatment and increase cure rate.