股骨近端结构测量指导髋部骨折术前方案

背景：髋部骨折在临床上很常见，治疗后常有骨质疏松和深静脉血栓形成等多种并发症，因此需要制定细致的治疗前计划。目的：对老年女性患者股骨近端结构进行测量，以帮助制定髋部骨折术前计划。方法：纳入2010年1月至2012年5月于福建医科大学附属第二医院就诊的临床需要拍骨盆平片的50岁或以上女性患者204例，应用实达易联众医用后处理软件对患者骨盆平片上股骨颈轴长、股骨颈中段宽度、股骨颈中段髓腔宽度、颈干角及髓腔闪烁指数进行测量。有股骨颈骨折的患者测量健侧，并依据患者的年龄进行分层分析。结果与结论：髋部平片测量结果显示，老年女性患者股骨颈轴长(97.14±6.16) mm，股骨颈中段宽度(33.76±3.03) mm，股骨颈中段髓腔宽度(28.28±3.48) mm，颈干角(127.05±3.43)°；髓腔闪烁指数为(3.50±0.55)。分层分析结果显示，随着患者年龄的增大，髓腔闪烁指数逐渐减小，且股骨颈骨折患者明显小于非股骨颈骨折患者(P < 0.01)。股骨近端结构测量有助于制定髋部骨折术前计划，选择内固定安放的最佳位置，根据髓腔闪烁指数有助于选择合适的股骨假体。

Geometry measurement of the proximal femur in the preoperative plan of hip fractures

BACKGROUND:Hip fracture is commonly seen, and frequently complicated with osteoporosis and deep vein thrombosis after treatment. Therefore, the careful preoperative plan is necessary.OBJECTIVE:To measure the geometric parameters of the proximal femur in the elderly female patients and to design the preoperative plan.METHODS:The pelvis radiographs of 204 female patients aged ≥ 50 years were collected between January 2010 and May 2012 from the Second Affiliated Hospital of Fujian Medical University. The geometric parameters, including femoral neck axis length, femoral neck width, medullary cavity width of femoral neck, femoral neck-shaft angle and canal flare index were measured with START-SOUTHERN medical software. The geometric parameters were measured in the contralateral hip for the patients with femoral neck fracture. Stratified analysis was done according to age.RESULTS AND CONCLUSION:The measurement results of hip plain films showed the femoral neck axis length of the old female patients was (97.14±6.16) mm, the femoral neck width was (33.76±3.03) mm, the medullary cavity width of femoral neck was (28.28±3.48) mm and the femoral neck-shaft angle was (127.05±3.43)°. The canal flare index was 3.50±0.55. Stratified analysis showed that, with aging, the canal flare index was reduced, and the canal flare index in the patients with femoral neck fracture was less than that in the non-fracture patients (P < 0.01). The measurement of the geometric parameters of the proximal femur was helpful to draw up the preoperative plan for patients with hip fracture and select the best placement of internal fixation. The canal flare index was beneficial for selecting the suitable prosthesis.