股骨皮质厚度参数及骨小梁密度在老年髋部骨折治疗中的临床意义

Clinical Significance of Hip Fracture in the Elderly with Cortical Thickness Parameters of Femur and Singh Index

目的:探讨临床上股骨颈骨折和转子间骨折股骨近端皮质骨及松质骨的结构差异。方法:收集骨质疏松性髋部骨折患者328例(≥65岁)为研究对象,分股骨颈骨折组和股骨转子间骨折组,测定患者健侧髋部的股骨上段皮质厚度指数(CTI)、峡距比(CC ratio)及Singh指数。结果:股骨颈骨折组CTI平均值为0.480±0.800,转子间骨折组为0.462±0.750,两组比较差异有统计学意义(P<0.05)。股骨颈骨折组CC ratio平均值为0.645±0.117,转子间骨折组为0.703±0.104,两组比较差异有统计学意义(P<0.05)。股骨颈骨折组Singh指数平均值为4.360±0.668,转子间骨折组为4.050±0.795,两组比较差异有统计学意义(P<0.05)。结论:股骨颈骨折与转子间骨折股骨近端皮质骨及松质骨结构存在差异,皮质骨厚度比率及骨小梁密度是影响髋部骨折类型的重要因素。

Objective:To explore the proximal femur structural differences of cortical bone and cancellous bone between the femoral neck fracture(FNF)and the intertrochanteric femoral fracture(IFF).Methods:Three hundred and twenty-eight patients(≥65 years)diagnosed as osteoporotic hip fracture were enrolled in our cohort study and assigned them into the FNF and the IFF groups;with their intact side proximal femur cortical thickness index(CTI),CC ratio,and Singh index were measured and assessed.Results:The average CTI was 0.480±0.800 at the FNF group,and 0.462±0.750 at the IFF group.The difference between the two was significant(P<0.05).The average CC ratio was 0.645±0.117 at the FNF group,and 0.703±0.104 at the IFF group.The difference between the two was significant(P<0.05).The average Singh index was 4.360±0.668 at the FNF group,and 4.050±0.795 at the IFF group.The difference between the two was significant(P<0.05).Conclusion:The structural of cortical bone and cancellous bone was different between the FNF and the IFF,the cortical thickness ratio and the density of bone trabecula may be one of the main factors for different types of the hip fracture.