目的:探讨髋部骨质疏松性骨折患者股骨近端几何结构的变化,结合骨密度测定,分析其对髋部骨质疏松性骨折危险性的影响.方法:选取2010年6月-2011年5月南华大学附属第一医院50岁以上受检者233例,其中髋部新鲜骨质疏松性骨折组46例,对照组187例,利用法国Osteocore 3双能X线骨密度仪及其配置的高级骨科专用分析测量工具包,测量股骨近端骨密度和几何结构,包括股骨颈轴长、颈干角、内侧偏距和颈长,进行统计学分析,比较各组间的差异.结果:髋部骨折组与对照组的股骨近端几何结构测量值均符合正态分布分析,与对照组比较,髋部骨折组中股骨颈轴长、内侧偏距和颈长均增大(P＜0.05),颈干角减小( P＜0.05),与其它各组有显著性差异.结论:髋部骨质疏松性骨折患者股骨颈轴长、颈干角、内侧偏距和颈长等股骨近端几何结构的特点,使骨骼负荷增加,是导致骨折发生的重要因素,结合骨密度测定,可以提高髋部骨质疏松性骨折风险的预测水平.%Objective: To evaluate the influence of hip osteoporotic fracture on geometric structure of the proximal femur, to study the influence of bone mineral density and its value in predicting hip osteoporotic fracture. Material and Methods: Two hundred and thirty-three cases examined by dual energy X-ray absorptiometry(DXA) were collected. There were 46 cases in the group of fresh hip osteoporotic fracture and 187 cases in the control group. Bone mineral density (BMD) and geometric structure of proximal femur(PFG) were measured for the uninjured hip of fracture group and the left hip of control group with Osteocore 3 DXA and senior orthopaedic special analysis tool, including femoral neck axis length (FNAL), femoral neck angle (FNA), medial offset(MO) and intertrochanter head(IH). Results: The FNAL, IH and MO in the hip fracture group were longer (P<0.05) than those in the control group, but the FNA was smaller (P<0.05). There were significantly difference between the two groups. Conclusions: The geometric structure difference of FNAL, FNA, MO, IH may add load to proximal femoral, which can increase the risk of hip fracture. Screening the osteoporotic patients with anomalous PFG and taking preventive measures and treatment are important to reduce the risk of hip fracture.
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