股骨头大小对股骨近端骨折定位的影响：400例回顾性分析

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-04-02 DOI:10.1016/j.jcot.2025.103007

Nele Wagener , Gregor Giebel , Felix Rarreck , Torsten Diekhoff , Sebastian Hardt

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引用次数: 0

摘要

背景：股骨近端骨折在老年人中普遍存在，导致高死亡率、生活质量下降和显著的医疗负担。随着人口老龄化，骨质疏松性骨折的发病率正在上升，到2050年，骨质疏松性骨折预计每年将达到600万例，耗资254亿美元。在85岁以上的人群中，股骨近端骨折的发生率预计将增加351%。通过影像学准确定位骨折，结合对股骨头大小和患者特异性因素的了解，可改善术前计划和预后。本研究探讨股骨头大小与骨折定位的关系。方法回顾性队列研究分析2010 - 2022年间400例股骨近端骨折患者的资料。骨折分为内侧、外侧、粗隆后和粗隆下。x线片测量了股骨头形态，并进行了统计分析，包括卡方检验、t检验、方差分析和logistic回归，确定了骨折定位的预测因素。结果股骨头面积（FHA）在不同骨折类型间差异显著，其中外侧骨折的平均FHA最大，为2355.95 mm2/cm2, p = 0.047。骨关节炎患病率差异有统计学意义（p = 0.028），股骨粗隆下骨折最高(17%,Kellgren &；Lawrence（3-4年级）。侧骨折患者平均年龄为71.05岁(p <；股骨粗隆骨折平均为79.52年(p <；0.001)。垂直(p <；0.001)和水平股骨头直径（p = 0.028）也有显著差异。结论股骨头较大常发生外侧骨折，而股骨粗隆骨折多发生在老年患者。转子下骨折与较小的股骨头和晚期骨关节炎有关。

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Impact of femoral head size on the localization of proximal femur fractures: Retrospective analysis of 400 cases

Background

Proximal femur fractures are prevalent among the elderly, leading to high mortality, reduced quality of life, and significant healthcare burdens. The incidence is rising with demographic ageing, with osteoporotic fractures projected to reach 6 million annually by 2050, costing $25.4 billion. A 351 % increase in proximal femur fractures among individuals over 85 years is expected. Accurate fracture localization through imaging, combined with understanding femoral head size and patient-specific factors, improves preoperative planning and outcomes. This study explores the relationship between femoral head size and fracture localization.

Methods

A retrospective cohort study analyzed data from 400 patients with proximal femur fractures treated between 2010 and 2022. Fractures were classified as medial, lateral, pertrochanteric, or subtrochanteric. Radiographs measured femoral head morphology, and statistical analyses, including chi-square tests, t-tests, ANOVA, and logistic regression, identified predictors of fracture localization.

Results

Femoral head area (FHA) varied significantly across fracture types, with lateral fractures having the largest mean FHA (2355.95 mm²/cm², p = 0.047). Osteoarthritis prevalence differed (p = 0.028), being highest in subtrochanteric fractures (17 %, Kellgren & Lawrence grade 3–4). Lateral fractures had a younger mean age of 71.05 years (p < 0.001), while pertrochanteric fractures averaged 79.52 years (p < 0.001). Vertical (p < 0.001) and horizontal (p = 0.028) femoral head diameters also differed significantly.

Conclusion

Larger femoral heads are associated with lateral fractures, whereas pertrochanteric fractures occur in older patients. Subtrochanteric fractures correlate with smaller femoral heads and advanced osteoarthritis.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.