股骨头颈压力骨小梁与股骨颈后内侧骨皮质及股骨距移行处的形态学观察及临床意义

李海艳, 黎萌, 杜心如

中国临床解剖学杂志 ›› 2025, Vol. 43 ›› Issue (1) : 1-8.

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中国临床解剖学杂志 ›› 2025, Vol. 43 ›› Issue (1) : 1-8. DOI: 10.13418/j.issn.1001-165x.2025.1.01
应用解剖

股骨头颈压力骨小梁与股骨颈后内侧骨皮质及股骨距移行处的形态学观察及临床意义

  • 李海艳1,2,    黎萌3,    杜心如3*
作者信息 +

Morphological observation and clinical significance of pressure bone trabeculae of femoral head and neck, posteromedial bone cortex of femoral neck and femoral calcar 

  • Li Haiyan1,2, Li Meng3, Du Xinru3*
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文章历史 +

摘要

目的    探讨股骨头颈压力骨小梁与股骨颈后内侧骨皮质及股骨距移行处形态特点,为明确股骨颈骨折发病机制提供形态学依据。 方法     股骨标本102具,分别拍摄正侧位、内斜45°、外斜45°位股骨上端X线片,观测股骨头颈压力骨小梁、股骨距和股骨颈后内侧皮质的位置关系;对股骨标本60具(正常组34具,骨质疏松组26具)头颈部行CT扫描及重建,比较两组压力骨小梁和股骨距形态差异;6具股骨标本沿股骨颈轴线的垂直面、冠状面、矢状面切开,观察压力骨小梁、股骨颈后内侧骨皮质及股骨距形态特点。应用Graphpad Prism v5.0软件进行数据分析。  结果    股骨头颈压力骨小梁向内后方汇合,止于股骨颈后内骨皮质并与股骨距相续;股骨距向外上发出股骨距大转子间骨小梁;骨质疏松组股骨距大转子间骨小梁萎缩变细。压力骨小梁与股骨距呈交叉连接,交叉处夹角[正常组(82.96±2.91)°,骨质疏松组(116.40±3.23)°],差异有统计学意义;横断面上股骨距夹角[正常组(17.52±0.71)°,骨质疏松组(13.09±0.90)°],差异有统计学意义。  结论     股骨头颈压力骨小梁与股骨距上端均附着在股骨颈后内侧骨皮质,股骨颈后内侧骨皮质及股骨距共同承接压应力,移行处是压力传导枢纽。骨质疏松时股骨距变小、移行处骨皮质薄弱是造成骨质疏松头颈型股骨颈骨折发生机制之一。

Abstract

Objective    To explore the morphological characteristics of pressure bone trabeculae of femoral head and neck, posteromedial bone cortex of femoral neck and femoral calcar, in order to provide morphological basis for the pathogenesis of femoral neck fracture.    Methods    A total of 102 femur specimens were collected. X-ray films of the upper end of the femur were taken at anteroposterior, lateral, 45° internal oblique and 45° external oblique, respectively. The position relationship of pressure bone trabeculae, calcar and posteromedial bone cortex of femoral neck were observed. Sixty cases of femoral specimens among them, there were 34 specimens in normal group and 26 cases in osteoporosis group. The head and neck of femur were scanned and reconstructed by CT. The morphological differences of pressure bone trabeculae and calcar were compared between the two groups. Six femur specimens were dissected along the vertical, coronal and sagittal surfaces of the femoral neck to observe the morphological characteristics of pressure bone trabeculae, posteromedial cortex of femoral neck and femoral calcar. The data were analyzed by Graphpad Prismv5.0 software.   Results   The pressure bone trabeculae of head and neck of femur concentrated inward and backward, and it stopped at posteromedial bone cortex of femoral neck and continued with the calcar. The greater intertrochanteric bone trabeculae of femoral calcar emerged outward from femoral calcar and thinned in osteoporosis group. The pressure bone trabeculae was cross-connected with femoral calcar, with an angle of (82.96±2.91)° in normal group and (116.40±3.23)° in osteoporosis group, and the difference was statistically significant. There was statistical difference  in the calcar angle on cross-section between two groups [(17.52±0.71)° in normal group and (13.09±0.90)° in osteoporosis group].    Conclusions    The pressure bone trabeculae of femoral head and neck, as well as the upper end of femoral calcar, are attached to the posteromedial bone cortex of femoral neck. The posteromedial cortex of femur neck and femoral calcar jointly bear compressive stress, and the migration site is the pressure transmission hubs. When osteoporosis occurs, femoral calcar becomes smaller, and the cortical bone at the junction between femoral calcar and pressure bone trabeculae is weaker. These may be one of the mechanisms of osteoporotic head-and-neck femoral neck fracture.

关键词

压力骨小梁;  /   / 股骨距;  /   / 股骨颈后内侧皮质;  /   / 骨质疏松;  /   / 股骨颈骨折

Key words

Pressure bone trabeculae;  /   / Femoral calcar;  /  Posteromedial cortex of femoral neck / Osteoporosis;  /   / Femoral neck fracture

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李海艳, 黎萌, 杜心如. 股骨头颈压力骨小梁与股骨颈后内侧骨皮质及股骨距移行处的形态学观察及临床意义[J]. 中国临床解剖学杂志. 2025, 43(1): 1-8 https://doi.org/10.13418/j.issn.1001-165x.2025.1.01
Li Haiyan, Li Meng, Du Xinru. Morphological observation and clinical significance of pressure bone trabeculae of femoral head and neck, posteromedial bone cortex of femoral neck and femoral calcar [J]. Chinese Journal of Clinical Anatomy. 2025, 43(1): 1-8 https://doi.org/10.13418/j.issn.1001-165x.2025.1.01
中图分类号: R322.7    

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基金

承德医学院高层次人才科研启动基金(202203);承德医学院人体解剖与组织胚胎学优势学科资助项目(202302)

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