定量CT对老年髋部骨折患者的股骨近端形态结构研究

Objective To better predict the risks of hip fracture by contrasting the differences of proximal femur geometry parameter between femoral neck fracture and intertrochanteric fracture with quantitative CT (QCT). Methods QCT were performed on 93 patients with hip fractures to measure the bone mineral density (BMD) of hip and to analyze hip geometry of unaffected side.The patients consisted of 21 males and 72 females,aged from 70 to 96 years old with an average age of (82.31±7.76) years old;31 of them were referred for intertrochanteric fracture and 62 for femoral neck fracture.Hip structure analysis (HSA) parameters included minimum cross-sectional area (CSA),cross-sectional moment of inertia (CSMI),cross-sectional modulus Z (Z score),buckling ratio (BR),cortical bone thickness (CTh) and hip axis length (HAL). Results For the two types of hip fractures measured by QCT in each proximal femur area,there was no statistical difference in th BMD (P>0.05).The CSA of femoral neck fracture group was smaller than that of intertrochanteric fracture group (P<0.05).The HAL of femoral neck fracture group was larger than that of intertrochanteric fracture group (P<0.05).The CTh in the superoanterior quadrant of femoral neck fracture group was smaller than that of intertrochanteric fracture group (P<0.05). Conclusions Aged people with small minimal CSA of femoral neck,long HAL and low CTh have a greater tendency for femoral neck fracture after falling down.