中国骨与关节杂志
中國骨與關節雜誌
중국골여관절잡지
Chinese Journal of Bone and Joint
2014年
11期
830-834
,共5页
危杰%伊辰%王满宜%王军%张玉富%高明%苏永彬%王玲%徐黎%程晓光
危傑%伊辰%王滿宜%王軍%張玉富%高明%囌永彬%王玲%徐黎%程曉光
위걸%이신%왕만의%왕군%장옥부%고명%소영빈%왕령%서려%정효광
骨密度%体层摄影术,X线%髋骨折%骨钉%定量CT
骨密度%體層攝影術,X線%髖骨摺%骨釘%定量CT
골밀도%체층섭영술,X선%관골절%골정%정량CT
Bone density%Tomography,X-ray%Hip fractures%Bone nails%Quantitative computed tomography
目的：探讨定量CT(quantitativecomputedtomography，QCT)测量股骨近端的松质骨骨矿物质密度(bonemineraldensity，BMD)对股骨近端内固定物头钉的选择的指导价值。方法选择2011年1月至2011年12月，我院收治的50例股骨颈骨折或股骨粗隆间骨折患者作为骨折组，其中男23例，女27例，年龄17～94(63.8±16.3)岁；招募75位年龄匹配的健康受试者作为健康组，其中男18例，女57例，年龄23～76(61.2±10.4)岁。使用QCT分别对骨折组健侧和健康组双侧股骨近端的不同兴趣区域内的BMD进行测量和分析。结果骨折组健侧股骨头、股骨颈及粗隆部的骨密度分别为(153.0±37.6)mg/cm3、(24.9±39.7) mg / cm3、(26.6±30.6) mg / cm3，健康组(左侧股骨近端)股骨头、股骨颈及粗隆部的骨密度分别为(220.2±46.1) mg/cm3、(74.8±49.1) mg/cm3、(70.8±41.3) mg/cm3，骨折组各部分骨密度均低于健康组，差异有统计学意义(P＜0.05)。股骨头与股骨颈和股骨粗隆部的骨密度下降的平均值不平行。结论骨质疏松是股骨近端骨折的危险因素；股骨粗隆部的骨密度并不能完全反映股骨头的骨密度；QCT 是目前测量股骨头骨密度的惟一方法；术前使用QCT评估股骨头的BMD对于内固定物头钉的正确选择提供了依据。
目的：探討定量CT(quantitativecomputedtomography，QCT)測量股骨近耑的鬆質骨骨礦物質密度(bonemineraldensity，BMD)對股骨近耑內固定物頭釘的選擇的指導價值。方法選擇2011年1月至2011年12月，我院收治的50例股骨頸骨摺或股骨粗隆間骨摺患者作為骨摺組，其中男23例，女27例，年齡17～94(63.8±16.3)歲；招募75位年齡匹配的健康受試者作為健康組，其中男18例，女57例，年齡23～76(61.2±10.4)歲。使用QCT分彆對骨摺組健側和健康組雙側股骨近耑的不同興趣區域內的BMD進行測量和分析。結果骨摺組健側股骨頭、股骨頸及粗隆部的骨密度分彆為(153.0±37.6)mg/cm3、(24.9±39.7) mg / cm3、(26.6±30.6) mg / cm3，健康組(左側股骨近耑)股骨頭、股骨頸及粗隆部的骨密度分彆為(220.2±46.1) mg/cm3、(74.8±49.1) mg/cm3、(70.8±41.3) mg/cm3，骨摺組各部分骨密度均低于健康組，差異有統計學意義(P＜0.05)。股骨頭與股骨頸和股骨粗隆部的骨密度下降的平均值不平行。結論骨質疏鬆是股骨近耑骨摺的危險因素；股骨粗隆部的骨密度併不能完全反映股骨頭的骨密度；QCT 是目前測量股骨頭骨密度的惟一方法；術前使用QCT評估股骨頭的BMD對于內固定物頭釘的正確選擇提供瞭依據。
목적：탐토정량CT(quantitativecomputedtomography，QCT)측량고골근단적송질골골광물질밀도(bonemineraldensity，BMD)대고골근단내고정물두정적선택적지도개치。방법선택2011년1월지2011년12월，아원수치적50례고골경골절혹고골조륭간골절환자작위골절조，기중남23례，녀27례，년령17～94(63.8±16.3)세；초모75위년령필배적건강수시자작위건강조，기중남18례，녀57례，년령23～76(61.2±10.4)세。사용QCT분별대골절조건측화건강조쌍측고골근단적불동흥취구역내적BMD진행측량화분석。결과골절조건측고골두、고골경급조륭부적골밀도분별위(153.0±37.6)mg/cm3、(24.9±39.7) mg / cm3、(26.6±30.6) mg / cm3，건강조(좌측고골근단)고골두、고골경급조륭부적골밀도분별위(220.2±46.1) mg/cm3、(74.8±49.1) mg/cm3、(70.8±41.3) mg/cm3，골절조각부분골밀도균저우건강조，차이유통계학의의(P＜0.05)。고골두여고골경화고골조륭부적골밀도하강적평균치불평행。결론골질소송시고골근단골절적위험인소；고골조륭부적골밀도병불능완전반영고골두적골밀도；QCT 시목전측량고골두골밀도적유일방법；술전사용QCT평고고골두적BMD대우내고정물두정적정학선택제공료의거。
Objective To investigate the potential value of the measurement of the cancellous bone mineral density ( BMD ) of the proximal femur by quantitative computed tomography ( QCT ) in the choice of adequate head screws in the management of proximal femur fractures.Methods A total of 50 patients with femoral neck or intertrochanteric fractures who were adopted from January 2011 to December 2011 were studied as the fracture group, including 23 males and 27 females. Their average age was ( 63.8±16.3 ) years old ( range: 17-94 years ). Other 75 age-sex matched and healthy patients were treated as the healthy group, including 18 males and 57 females. Their average age was ( 61.2±10.4 ) years old ( range: 23-76 years ). The BMD in different regions of interest ( ROI ) of the proximal femur were measured and analyzed by QCT for uninjured sides of the fracture group and bilateral sides of the healthy group.Results The BMD of the femoral head, femoral neck and trochanter in the fracture group were ( 153.0± 37.6 ) mg/cm3, ( 24.9±39.7 ) mg/cm3 and ( 26.6±30.6 ) mg/cm3 respectively, which were obviously lower than ( 220.2± 46.1 ) mg/cm3, ( 74.8±49.1 ) mg/cm3, ( 70.8±41.3 ) mg/cm3 in the healthy group. And the differences between them were statistically signiifcant (P<0.05 ). It was noticed that the decrease of BMD of the femoral head was not parallel with that of the neck and trochanter on average.Conclusions Osteoporosis is a risk factor for proximal femoral fractures, and the BMD of the femoral trochanter sometimes can’t fully relfect that of femoral head. So far, QCT is the only way to assess the BMD of the femoral head. Thus, the preoperative QCT assessment of the BMD of the femoral head is quite helpful in the choice of proper head screws of the implants.
