Objective To analyze the correlation between the Singh index and the biomechanical properties of femoral head bearing area in postmenopausal women and men with hip fracture.Methods Forty-two patients with femoral neck fracture or intertrochanteric fracture including 21 males and 21 postmenopausal women (menopause≥1 year) received total hip replacement.Singh index (SI) was calculated before the operation.Main bearing region of the femoral head was collected to detect the biomechanical properties about stress and elastic modulus.The correlation between the Singh index and the biomechanical properties of femoral head bearing area was analyzed by Spearman analysis.Results In 42 cases of patients, there was 1 case of SI grade Ⅰ, 13 cases of grade Ⅱ, 14 cases of grade Ⅲ , 10 cases of grade Ⅳ, 3 cases of grade Ⅴ, and 1 case of grade Ⅵ, including 0 case of grade Ⅰ, 4 cases of grade Ⅱ, 6 cases of grade Ⅲ, 7 cases of grade Ⅳ, 3 cases of grade Ⅴ and 1 case of grade Ⅵ in males, and 1 case of grade Ⅰ, 9 cases of grade Ⅱ, 8 cases of grade Ⅲ, 3 cases of grade Ⅳ, 0 cases of grade Ⅴ and 0 case of grade Ⅵ in females.The SI of females was lower than that of males (P<0.05).The bivariate of stress in 42 patients with hip fracture was (14.09±1.31) Pa, and the bivariate of stress of females [(12.26±1.03) Pa] was lower than that of males [(15.93±1.15) Pa] (P<0.05).The bivariate of elastic modulus of 42 patients was (128.32±21.36) MPa, and the bivariate of elastic modulus of females [(113.06±19.52) MPa] was lower than that of males [(143.58±25.26) MPa] (P<0.05).Spearman rank correlation analysis showed that the SI was positively correlated with the bivariate of stress in 42 patients with hip fracture (r=0.884, P<0.001).Meanwhile, the SI was positively correlated with the bivariate of stress in males and females (r=0.934, 0.838;all P<0.001).Spearman rank correlation analysis showed that the SI was positively correlated with the bivariate of elastic modulus in 42 patients with hip fracture (r=0.734, P<0.001).Meanwhile, the SI was positively correlated with the bivariate of elastic modulus in males and females (r=0.832, 0.580;all P<0.001).Conclusions The Singh index grading is positively correlated with the bivariate of stress and bivariate of elastic modulus in postmenopausal women with hip fracture.Therefore, we can infer the biomechanical properties of the femoral head bearing region according to the Singh index.%目的 分析绝经后女性髋部骨折患者及男性患者股骨近端骨小梁类型指数(Singh指数)与股骨头承重区生物力学指标的相关性.方法 选择因股骨颈、转子间骨折行髋关节置换术的42例患者,其中男21例、女21例(绝经≥1年),术前均行X线片测算Singh指数,术中留取股骨头主要承重区,测量其应力、弹性模量等生物力学性能指标,采用Spearman相关性分析法分析患者Singh指数与股骨头承重区生物力学指标的相关性.結果 42例髋部骨折患者患者Singh指数分级为Ⅰ级1例、Ⅱ级13例、Ⅲ级14例、Ⅳ级10例、Ⅴ级3例、Ⅵ级1例;其中男性患者分级为Ⅰ级0例、Ⅱ级4例、Ⅲ级6例、Ⅳ级7例、Ⅴ级3例、Ⅵ级1例;女性患者分级为Ⅰ级1例、Ⅱ级9例、Ⅲ级8例、Ⅳ级3例、Ⅴ级0例、Ⅵ级0例.女性患者Singh指数分级低于男性(P<0.05).42例髋部骨折患者的骨极限应力为(14.09±1.31)Pa,男性和女性分别为(15.93±1.15)、(12.26±1.03)Pa,二者比较,P<0.05.42例患者弹性模量(128.32±21.36)MPa,男性和女性患者分别为(143.58±25.26)、(113.06±19.52)MPa,二者比较,P<0.05.Spearman相关性分析显示,42例髋部骨折患者患者的Singh指数分级与骨极限应力呈正相关(r=0.884,P<0.001).男性、女性Singh指数分级与骨极限应力均呈正相关(r分别为0.934,0.838;P均<0.001).42例髋部骨折患者患者的Singh指数分级与弹性模量呈正相关(r=0.734,P<0.001).男性、女性Singh指数分级与弹性模量均呈正相关(r分别为0.832,0.580;P均<0.001).结论 绝经后女性髋部骨折患者Singh指数分级与骨极限应力、弹性模量呈正相关.绝经后女性髋部骨折患者可根据Singh指数分级推断股骨头承重区骨的生物力学情况.
展开▼
