CT observation of the morphological changes of the femoral head and neck in osteoporosis and its clinical significance

doi:10.13418/j.issn.1001-165x.2025.3.01

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Chinese Journal of Clinical Anatomy ›› 2025, Vol. 43 ›› Issue (3) : 243-248. DOI: 10.13418/j.issn.1001-165x.2025.3.01

CT observation of the morphological changes of the femoral head and neck in osteoporosis and its clinical significance

Li Haiyan^1,2, Wu Di³, Yang Zhipeng¹, Du Xinru⁴*

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Abstract

Objective To investigate the correlation between osteoporotic femoral head and neck fractures and changes in cortical thickness, diameter, area and the morphology of the femoral head and neck, so as to elucidate the pathogenesis of femoral neck fractures. Methods 65 dry femoral specimens were collected, with 30 osteoporosis and 35 normal specimens. CT scanning and digital reconstruction were performed to analyze the thickness of bone cortex, the diameter and area of the femoral head and neck. The ratio of the diameter and area of each part was calculated, and morphological changes of bone tissue were observed under scanning electron microscopy. Results Compared with the normal group, the thickness of the medial and lateral cortex at the junction of the femoral head and neck and the medial cortex at the middle of femoral neck in the osteoporosis group were lower, the ratio of the maximum diameter of the femoral head to the diameter at the middle of the femoral neck was significantly higher in the osteoporosis group. In addition, the ratio of the maximum cross-sectional area of the femoral head to the basal area significantly increased in the osteoporosis group. The arrangement of bone lamella was irregular in the bone cortex, with loose structures and disordered arrangement of bone trabecula in the osteoporosis group. Conclusions In osteoporosis, bone cortex at the junction of the femoral head and neck and medial cortex at the middle of the femoral neck are relatively weak, and femoral head is larger and neck is smaller in shape. Loose bone plates and disordered trabecular arrangement appeared in the femoral neck, which may be the morphological basis for the occurrence of osteoporotic femoral neck fractures.

Key words

Femoral neck fracture; / / CT three-dimensional reconstruction; / / Thickness of cortical bone; / / Scanning electron microscope

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Li Haiyan, Wu Di, Yang Zhipeng, Du Xinru. CT observation of the morphological changes of the femoral head and neck in osteoporosis and its clinical significance[J]. Chinese Journal of Clinical Anatomy. 2025, 43(3): 243-248 https://doi.org/10.13418/j.issn.1001-165x.2025.3.01

References

[1] Zhang YZ, Su YL, Hao JD, et al. Clinical epidemiology of orthopedic trauma[M]. Stuttgart:Georg Thieme Verlag, 2012:163-175.

[2] 续开亮, 杜心如. 股骨颈骨折解剖分型与骨质疏松程度关系的临床研究[J]. 中华解剖与临床杂志, 2015, 20(4): 330-333. DOI:10.3760/cma.j.issn.2095-7041.2015.04.011.

Xu KL, Du XR. Research of the relationship between anatomical types of femoral neck fractures and degree of osteoporosis [J]. Chin J Anat Clin, 2015, 20(4): 330-333. DOI:10.3760/cma.j.issn.2095-7041. 2015.04.011.

[3] Bryan R, Nair PB, Taylor M. Use of a statistical model of the whole femur in a large scale, multi-model study of femoral neck fracture risk[J]. J Biomech,2009,42(13):2171-2176. DOI:10.1016/j.jbiomech. 2009. 05.038.
[4] Wang Q, Teo JW, Ghasem-Zadeh A, et al. Women and men with hip fractures have a longer femoral neck moment arm and greater impact load in a sideways fall[J]. Osteoporos Int, 2009, 20(7): 1151-1156. DOI:10.1007/s00198-008-0768-y.
[5] 李海艳,司丽娜, 要星晨, 等. 股骨颈滋养孔的形态特点及临床意义[J].中国临床解剖学杂志, 2023, 41(3):258-262.DOI:10.13418/j.issn.1001-165x.2023.3.03.
Li HY Si LN, Yao XC, et al. Morphological characteristics of nutrient foramina on femoral neck and its clinical significance [J]. Chin J Clin Anat, 2023, 41(3):258-262.DOI:10.13418/j.issn.1001-165x.2023.3.03.
[6] 崔志刚, 杜心如, 孔祥玉. 骨质疏松时股骨颈结构薄弱区影像解剖学观察及其临床意义[J]. 中国临床解剖学杂志, 2016, 34(5): 504-508. DOI:10.13418/j.issn.1001-165x.2016.05.006.
Cui ZG, Du XR, Kong XY. Radiological anatomy of the structural weak region in the femoral neck in the osteoporosis and its clinical significance [J]. Chin J Clin Anat, 2016, 34(5): 504-508. DOI:10.13418/j.issn.1001-165x.2016.05.006.
[7] Sundh D, Mellström D, Nilsson M, et al. Increased cortical porosity in older men with fracture[J]. J Bone Miner Res, 2015, 30(9): 1692-1700. DOI:10.1002/jbmr.2509.
[8] Chen M, Yuan H. Assessment of porosity index of the femoral neck and tibia by 3D ultra-short echo-time MRI[J]. J Magn Reson Imaging, 2018, 47(3):820-828.DOI: 10.1002/jmri.25782.
[9] 陈华芳, 李珊珊, 郭兴满, 等. 老年人髋部骨折股骨近端骨质CT测量的意义[J]. 中国矫形外科杂志, 2021, 29(18): 1706-1708. DOI:10.3977/j.issn.1005-8478.2021.18.18.
Chen HF, Li SS, Guo XM, et al. CT measurement of proximal femoral bone quality for evaluation of hip fractures in the elderly [J]. Orthopedic Journal of China, 2021, 29(18): 1706-1708. DOI:10.3977/j.issn.1005-8478.2021.18.18.
[10]Endo D, Ogami-Takamura K, Imamura T, et al. Reduced cortical bone thickness increases stress and strain in the female femoral diaphysis analyzed by a CT-based finite element method: Implications for the anatomical background of fatigue fracture of the femur[J]. Bone Rep, 2020,13:100733. DOI: 10.1016/j.bonr.2020.100733.
[11] 杜心如, 卢世璧. 骨质疏松时股骨上段髓腔形态学特点及其临床意义[J]. 中国临床解剖学杂志, 2006, 24(6): 631-633. DOI:10.13418/j.issn.1001-165x.2006.06.013.
Du XR, Lu SB. The morphological characteristics of the proximal femoral canal of osteoporoses and its clinical significance [J]. Chin J Clin Anat, 2006,24(6): 631-633. DOI:10.13418/j.issn.1001-165x. 2006. 06.013.