骨质疏松性头颈型股骨颈骨折股骨头的显微CT观察

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Abstract Objective〓To investigate the regions of structural vulnerability within the femoral head of patients suffering from osteoporotic femoral neck fractures，aiming to contribute insights into the underlying mechanisms of such fractures and inform future research endeavors.Methods〓Utilizing micro-CT scanning technology，we examined six femoral head specimens procured from patients ［(5 males and 1 female，aged 68~82 years，mean age (73.17±4.92)years；3 left-sided and 3 right-sided)］ with confirmed osteoporotic femoral neck fractures，admitted to Beijing Chao-Yang Hospital，Capital Medical University.High-resolution imaging enabled us to reconstruct and comprehensively analyze the bone microstructure in three distinct yet critical areas：The peripheral region of the femoral head，the supralateral quadrant of the femoral head，and the inferior aspect proximal to the fracture site within the femoral neck.Subsequently，we conducted a comparative analysis of bone structural parameters across these regions to identify potential areas of weakness.Results〓In comparing the supralateral region of the femoral head to its peripheral zones，no statistically significant variations were observed in trabecular separation，thickness，number，structural model index，trabecular connectivity density，tissue bone mineral density，volume bone mineral density，bone volume fraction，or bone surface/volume ratio (P＞0.05).However，three-dimensional reconstructions of the supralateral area revealed increased trabecular separation，decreased trabecular thickness，and a noticeable decrease in trabecular number，accompanied by a more rod-like trabecular structure，indicative of structural weakening.Contrastingly，the lowest region of the femoral neck fracture demonstrated statistically significant increases in trabecular thickness，bone mineral density，and bone volume fraction compared to the peripheral regions，while the bone surface/volume ratio and structural model index decreased significantly (P＜0.05).Despite this，trabecular separation，number，and connectivity density did not exhibit statistically significant differences (P＞0.05).Three-dimensional reconstructions highlighted that the trabecular thickness in the lowest region of the fracture was notably thicker than in the peripheral zones，exhibiting a more plate-like trabecular structure.Conclusion〓The supralateral region of the femoral head is a potentially weak structure that may be prone to fracture during sideways falls.There was no apparent bone weakness at the bottom of the fracture site in the medial aspect of the femoral neck.

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[1]	. [J]. sygkzz, 2024, 30(8): 740-.