CAJ | 학술논문

目的：比较骨质疏松性股骨颈骨折和转子间骨折患者在髋部骨密度及几何结构上的不同特点。方法将137例50岁以上髋部骨折的患者分为两组：股骨颈骨折组69例，男20例，女49例，年龄50－97岁（75．1±9．6），体重指数（BMI）：21．6±4．1 kg／m2；股骨转子间骨折组48例，男16例，女32例，年龄50－91岁（78．1±9．1），体重指数（BMI）：21．5±4．3 kg／m2。对所有患者的健侧股骨近端行双能X线骨密度仪（ Dual energy X－ray absorptiometry，DXA）测定，并利用该仪器的HSA软件分析髋部几何结构参数。结果两组患者在男女构成比例、年龄、身高、体重、体重指数的比较上没有统计学差异（ P＜0．05）；两组患者的骨密度在股骨颈区（ Neck）、大转子区（ Troch）、Ward区、转子间区（ Inter）、全髋（ Total hip）的比较上没有统计学差异（ P＜0．05）。两组患者在股骨颈区及转子间区的横截面积（CSA）、横截面转动惯量（CSMI）、屈曲应力比（BR）的比较上均没有统计学差异（P＜0．05）；两组患者在股骨颈区域的皮质骨厚度的比较上没有统计学差异（P＜0．05）；两组患者在转子间区域的皮质骨厚度的比较上有统计学差异（ P＝0．013）。结论在脆性髋部骨折的不同骨折类型的发生机制上，皮质骨变薄是引起不同髋部骨折类型的一个主要因素，尤其是对于高龄的髋部骨折患者。
목적：비교골질소송성고골경골절화전자간골절환자재관부골밀도급궤하결구상적불동특점。방법장137례50세이상관부골절적환자분위량조：고골경골절조69례，남20례，녀49례，년령50－97세（75．1±9．6），체중지수（BMI）：21．6±4．1 kg／m2；고골전자간골절조48례，남16례，녀32례，년령50－91세（78．1±9．1），체중지수（BMI）：21．5±4．3 kg／m2。대소유환자적건측고골근단행쌍능X선골밀도의（ Dual energy X－ray absorptiometry，DXA）측정，병이용해의기적HSA연건분석관부궤하결구삼수。결과량조환자재남녀구성비례、년령、신고、체중、체중지수적비교상몰유통계학차이（ P＜0．05）；량조환자적골밀도재고골경구（ Neck）、대전자구（ Troch）、Ward구、전자간구（ Inter）、전관（ Total hip）적비교상몰유통계학차이（ P＜0．05）。량조환자재고골경구급전자간구적횡절면적（CSA）、횡절면전동관량（CSMI）、굴곡응력비（BR）적비교상균몰유통계학차이（P＜0．05）；량조환자재고골경구역적피질골후도적비교상몰유통계학차이（P＜0．05）；량조환자재전자간구역적피질골후도적비교상유통계학차이（ P＝0．013）。결론재취성관부골절적불동골절류형적발생궤제상，피질골변박시인기불동관부골절류형적일개주요인소，우기시대우고령적관부골절환자。
Objective To analyze the differences of femoral geometry and bone mineral density between osteoporotic femoral neck fractures and trochanteric fractures from DXA scans.Methods A total of 137 patients were divided into femoral neck fracture group and trochanteric fracture group.There were 69 patients in femoral neck fracture group including 20 males and 49 females ( age 50-97 years, mean 75.1 ±9.6 years, BMI 21.6 ±4.1 kg/m2 ) .There were 48 patients in trochanteric fracture group including 16 males and 32 females ( age 50-91 years, mean 78.1 ±9.1 years, BMI 21.5 ±4.3 kg/m2 ) .BMD of bilateral hip of all the patients was performed using dual-energy X-ray absorptiometry ( DXA ) , and femoral geometry parameters were analyzed using the Hip Structural Analysis (HSA) software.Results There was no statistically difference (P >0.05) in the proportion of men and women, age, height, weight, and BMI between the two groups.There was no statistically difference (P>0.05) of BMD in Neck, Troch, Ward’s region, and Inter and Total hip between the two groups.There was no statistically difference (P>0.05) in CSA, CSMI, and BR of the neck and intertrochanteric region between the two groups.There was no statistically difference (P>0.05) in the neck cortical thickness between the two groups.The cortical thickness in intertrochanteric region in patients of the trochanteric fracture group was thinner than that in femoral neck fracture group ( P<0.05 ) .Conclusion On the mechanism of fragile hip fracture, it seems that the thinning of the cortical thickness is one of the main factors for different types of the hip fracture, especially in elderly hip fracture patients.