腰大肌面积与股骨转子间骨折后对侧髋部骨折的相关性分析

目的: 探讨初次转子间骨折时腰大肌区域面积与再发对侧髋部骨折的关系。方法: 选取2008年1月至2011年1月股骨转子间骨折患者87例在首次骨折时进行腰椎及髋部CT扫描,根据对侧髋部是否发生骨折分为两组,其中对侧髋部骨折组13例,男5例,女8例,年龄(82.30±5.66)岁;非对侧髋部骨折组74例,男32例,女42例,年龄(79.70±5.84)岁。观察比较两组患者性别,年龄,术前血白蛋白值,骨折侧,体质量指数(body mass index,BMI),术后1年髋关节Harris评分、术前Barthel指数、术前合并内科疾病,以腰大肌指数(Psoas major index,PMI)比较两组术前CT腰大肌面积,评估初次骨折时腰大肌面积与对侧髋部骨折相关性。结果: 两组患者术后随访均2年以上,两组的PMI值差异有统计学意义(P<0.05)。患者术前PMI与对侧髋部再次骨折的时间之间存在明显的正相关性(r=0.641,P=0.018)。结论: 对侧髋关节骨折患者腰大肌区域面积存在差异,故腰大肌面积可作为对侧髋部骨折的重要危险因素。

Correlation between psoas muscle area and contralateral hip fracture after intertrochanteric fracture

Objective: To investigate the relationship between the area of psoas major muscle(PMI) and recurrent contralateral hip fracture in the initial intertrochanteric fracture. Methods: Total of 87 patients with intertrochanteric fracture of femur from January 2008 to January 2011 were selected for CT scanning of lumbar spine and hip at the time of the first fracture,and then divided into two groups according to whether there was fracture in the contralateral hip,13 patients in the contralateral hip fracture group,5 males and 8 females,aged(82.30±5.66) years;there were 74 cases in the non contralateral hip fracture group,including 32 males and 42 females,with an age of (79.70±5.84) years. The gender,age,preoperative blood albumin value,operation side,body mass index(BMI),Harris score of hip joint one year after operation,Barthel index before operation and medical diseases before operation were observed and compared between two groups. The PMI was used to compare the area of psosa major on CT before operation in two groups,and the correlation between the area of PMI at the time of initial fracture and the fracture of the contralateral hip was evaluated. Results: The two groups were followed up for more than 2 years after operation. There was a significant difference in PMI between two groups(P<0.05). There was a significant positive correlation between preoperative PMI and the time of re fracture of the contralateral hip(r=0.641,P=0.018). Conclusion: There are differences in the area of PMI in patients with contralateral hip fracture,so the area of PMI can be regarded as an important risk factor for contralateral hip fracture.