老年人股骨转子间骨折骨活检与骨微结构的临床研究
李建赤, 梁江声, 李康, 陈惠平, 蔡跃波, 徐自强, 谭加群, 谢伟健
中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (2) : 226-228.
老年人股骨转子间骨折骨活检与骨微结构的临床研究
The clinical study of bone biopsy and bone microstructure of elderly intertrochanteric fractures
目的 通过对老年人股骨转子间骨折部位进行骨活检与骨微结构研究,了解其骨微结构组织形态学参考值,以指导治疗。 方法 实验组:选择低、中度能量创伤所致股骨转子间骨折需要手术治疗的男、女性老年病例各15例;对照组:男女各选12 例新鲜尸体的股骨标本。用直径为1 cm的环钻于股骨转子间区按统一标准定位后,钻取高2 cm、直径1 cm的圆骨柱,进行骨活检与骨微结构组织形态观察和计量分析。 结果 老年人股骨转子间骨小梁连接减少从而整个小梁逐渐丧失,在一定宽度(mm)条件下骨小梁较稀疏,骨小梁面积占骨组织面积的百分率较小,两个骨小梁之间的平均距离较大,骨小梁结点相对较少,而骨小梁游离末端数相对多。两组间Tb.N、 Tb.Wi、 Tb.Sp、 %Tb.Ar、 N/F比较,差异均有统计学意义(P < 0. 05)。 结论 老年人股骨转子间区骨微结构组织形态参数值对抗骨质疏松治疗及合适的功能锻炼具有重要指导意义。
Objective To obtain the reference value of the bone micrstructrual morphology for therapeutic guidance by investigation of bone microstructure in bone biopsy from intertroachteric fractures in elderly patients. Methods The experimental group: 15 female patients and 15 male patients were who have femoral intertrochanteric fracture caused by low or moderate energy trauma and need of surgical treatment were included. Control group: 24 fresh cadaveric femoral specimens, 12 from male and 12 from female, were included. A Trephine with a diameter of 1 cm was used to obtain a bone column with a size being 2cm in height and 1cm in diameter (the drill was placed on the intertrochanteric region by a uniform approach). The bone column was used for microstructural morphological study and quantitative analysis. Results The trabecular connectivity decreased and the trabecula gradually disappeared. in a certain width of bone, the trabecula was sparse and the percentage of trabecular area versus the whole bone area was relatively small. The average distance between trabeculae was long and the number of trabecularnodes was relatively small, while the free ends of the bone trabeculae increased. Comparison of Trabecular number, Trabecular width, Trabecular separation, %Trabecular bone area, Number of nodes/Free end between the two groups revealed significantly statistical difference(P<0.05). Conclusions The elderly femoral intertrochanteric bone microstructure morphologic parameters have important guiding significances to osteoporosis treatment and appropriate functional exercise.
  / 股骨 / 股骨转子间骨折 / 骨活检 / 骨组织形态计量学 / 骨结构
Femur / Femoral intertrochanteric fracture / Bone biopsy / Bone histomorphometry / Bone structure
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佛山市医学类科技攻关项目(201208276)
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