骨密度结合股骨近端几何参数预测老年髋部骨折

目的研究老年人骨密度(Bone mineral density,BMD)值结合股骨近端几何参数是否能提高骨质疏松性髋部骨折危险性的预测。方法将85例绝经后妇女髋部骨折患者按骨折类型分组, 其中52例股骨颈骨折,33例转子间骨折。对照组100例老年女性。在骨盆片上测量股骨近端几何参数,在股骨颈、Ward’s三角和转子处测量BMD值,对结果进行统计学处理分析。结果骨折组的BMD值均低于对照组(P<0．01);股骨干皮质厚度与股骨颈BMD值有相关性(r=0．45,P< 0．01);逐步线性回归分析结果显示股骨距内侧皮质厚度、转子处BMD值、颈干角和Ward’s三角 BMD值相结合是预测髋部骨折最好方法(r=0．74,r2=0．53,P<0．01)。结论骨密度值结合放射学测量股骨近端几何参数能提高对骨质疏松性髋部骨折及骨折类型的预测。

Prediction of hip fracture in elderly women with the combination of BMD and proximal femur geometrical parameters

Objective To study whether the combination of upper femur geometrical parameters and BMD could improve the prediction of osteoporotic hip fractures risk in the elderly females. Methods Eighty-five postmenopausal females with hip fracture were included in the study group with 52 had cervical fracture and 33 trochanteric fracture. The control group consisted of 100 age-matched women. The geometrical parameters were defined from anterioposterior pelvic roentgenograms. BMD was measured at the femoral neck, Ward's triangle, and the trochanter area. Results BMD was significantly lower in all fracture groups than that in the controls (P<0. 01). Significant correlation was shown between the femoral neck cortex width and the femoral neck BMD (r=0. 45, P<0. 01). Stepwise linear regression analysis showed that the best predictor of hip fracture was the combination of medical calcar femoral cortex width, the trochanter BMD, neck/shaft angle, and Ward's triangle BMD ( r=0. 74, r2 =0. 53, P<0. 01) . Conclusions The combination of BMD and radiological measures of upper femur geometry could improve the assessment of the risks for osteoporotic hip fracture and the types of fractures.