CAJ | 학술논문

目的：研究脆性股骨颈骨折的股骨颈皮质骨厚度和骨密度变化。方法对76例病人行股骨近端CT扫描，骨质疏松性股骨颈骨折组42例，非骨折组34例。取对侧（正常侧）股骨小转子顶点上方20 mm（ T20）平面CT横截面影像，计算T20长径和股骨颈寛径皮质比率，作为评估皮质厚度的指标；用DXA测量股骨颈骨密度，了解骨质疏松程度。结果 T20长径皮质比率：骨质疏松性股骨颈骨折组：（17.57±3.54）％；非骨折组：（21.64±3.75）％（P＝0.000）；T20股骨颈宽径皮质比率：骨质疏松性股骨颈骨折组：（25.98±5.51）％；非骨折组：（32.89±5.74）％（P＝0.000）。骨密度：骨折组：0.590±0.084 g/cm2；非骨折组：0.698±0.138 g/cm2， P＜0.000。结论股骨颈皮质变薄和骨密度降低是导致脆性股骨颈骨折重要因素，T20长径皮质比率和T20股骨颈宽径皮质比率是观察股骨颈皮质骨变化的有效指标。
목적：연구취성고골경골절적고골경피질골후도화골밀도변화。방법대76례병인행고골근단CT소묘，골질소송성고골경골절조42례，비골절조34례。취대측（정상측）고골소전자정점상방20 mm（ T20）평면CT횡절면영상，계산T20장경화고골경관경피질비솔，작위평고피질후도적지표；용DXA측량고골경골밀도，료해골질소송정도。결과 T20장경피질비솔：골질소송성고골경골절조：（17.57±3.54）％；비골절조：（21.64±3.75）％（P＝0.000）；T20고골경관경피질비솔：골질소송성고골경골절조：（25.98±5.51）％；비골절조：（32.89±5.74）％（P＝0.000）。골밀도：골절조：0.590±0.084 g/cm2；비골절조：0.698±0.138 g/cm2， P＜0.000。결론고골경피질변박화골밀도강저시도치취성고골경골절중요인소，T20장경피질비솔화T20고골경관경피질비솔시관찰고골경피질골변화적유효지표。
Objective To study the changes of the cortical thickness of the femoral neck in fragile femoral neck fractures .Methods The CT scan of the proximal femur in 76 patients was performed .Forty-two patients with had osteoporotic femoral neck fractures , including 12 males and 30 females, with an average age of 74.4 ±9.3 yrs.Thirty-four patients, including 12 males and 22 females, were in non-fracture group, with an average age of 63.3 ±9.3 yrs.The parameters were defined from the CT films at T 20 level ( the neck at 20 mm higher than the apex of lesser trochanter ) in the contralateral (normal side) hip.The cortex ratio of T20 long diameter and the cortex ratio of wide diameter of the neck at T 20 were calculated for the evaluation of the changes of the cortical thickness of the femoral neck.BMD of the femoral neck was detected using DXA to evaluate the severity of osteoporosis .Results The cortex ratio of T20 long diameter in the fracture group and non-fracture group was 17.57 ±3.54% and 21.64 ±3.75%, respectively (P=0.000). The cortex ratio of wide diameter of the neck at T 20 in the fracture group and non-fracture group was 25.98 ±5.51 % and 32.89 ± 5.74%, respectively (P=0.000).BMD of the femoral neck in the fracture group and the non-fracture group was 0.590 ±0.084 g/cm2 and 0.698 ±0.138g/cm2, respectively (P<0.000).Conclusion The thinned cortex and decreased BMD of the femoral neck are the main factors leading to fragile femoral neck fractures .The cortex ratio of T 20 long diameter and wide diameter of neck at T 20 is effective index to evaluate the changes of the femoral neck cortex .