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Are radiographic indices reliable indicators for quantitative bone mineral density and vitamin D status after femoral neck fractures? A retrospective study in 112 elderly patients

机译:放射影像学指标是否可作为股骨颈骨折后定量骨矿物质密度和维生素D状态的可靠指标?回顾性研究112例老年患者

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Radiographic parameters and indices obtained from hip x-rays are a potential tool to promptly estimate bone quality in elderly hip fracture patients. Preoperative decision in whether to use cemented or cement augmented implants might be supported by this information and thus improve patient safety. Subsequently, this study was conducted to evaluate radiographic parameters as a prescreening tool for bone quality. A retrospective analysis of 112 elderly patients with a femoral neck fracture after low-energy trauma was performed (81?% female, 19?% male). Three radiological indices were calculated on hip x-rays: cortical index antero-posterior CTI (ap), cortical index lateral CTI (lat) and canal to calcar ratio CCR. These indices were analyzed for correlations with DXA T-Scores and serum 25-hydroxyvitamin D (25(OH)D) using the Spearman test. Median age of patients was 80 (IQR 72–86) years. A linear correlation was found for CTI (lat) and T-Score at the total hip (p?
机译:从髋部X射线获得的射线照相参数和指标是迅速评估老年髋部骨折患者骨质的潜在工具。该信息可支持在术前决定是否使用骨水泥或骨水泥增强植入物,从而提高患者安全性。随后,进行了这项研究,以评估射线照相参数作为骨质量的预筛工具。回顾性分析了112例低能量创伤后老年股骨颈骨折患者(女性81%,男性19%)。在髋部X射线片上计算了三个放射学指标:皮质指标前后CTI(ap),皮质指标外侧CTI(lat)和管与颅骨比CCR。使用Spearman检验分析了这些指数与DXA T分数和血清25-羟基维生素D(25(OH)D)的相关性。患者的中位年龄为80(IQR 72–86)岁。在整个髋部(p <0.001,r = 0.589),股骨颈(p = 0.005,r = 0.405)和CTI(lat)和T-Score呈线性相关。脊柱(p≤0.002,r≤0.299)。在CTI(lat)和25(OH)D之间也显示出显着的相关性(p≤0.002,r≤0.293)。临界水平为0.4的CTI(lat)在预测整个髋关节的T分数≤≤2.5时显示出79%的敏感性和56%的特异性。性别特异性分析显示,对于男性而言,CTI(lat)的敏感性(100 %%)和特异性(73 %%)更高(截止值为0.4)。对于严重的维生素D缺乏症(<10?ng / ml),敏感性和特异性分别为75%和65%。 X射线照相指数(CTI)显示与BMD和血清25OH维生素D水平直接相关。建议使用CTI(lat)临界值0.4来鉴别具有T-Scores≤≤2.5和严重维生素D缺乏症所表示的骨质疏松症风险的患者。

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