Yamamoto Takuaki, Karasuyama Kazuyuki, Iwasaki Kenyu, Doi Toshio, Iwamoto Yukihide
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan,
Arch Orthop Trauma Surg. 2014 Sep;134(9):1199-203. doi: 10.1007/s00402-014-2044-2. Epub 2014 Jul 10.
Subchondral insufficiency fracture of the femoral head (SIF) has been reported to be observed mainly in the elderly osteoporotic females and most of the studies on SIF have been made based on female patients. The purpose of this study is to document the clinical characteristics of SIF observed in male patients.
Between 2001 and 2011, we have diagnosed 39 consecutive SIF hips in our department, based on imaging studies and/or histologic examinations. Among them, 14 hips (35.8%) were of male SIF patients. Their clinico-radiological characteristics were reviewed.
The age range in male SIF patients was 16-62 (ave. 44 years), while that in females was 22-84 (ave. 66 years) (p < 0.001). In male patients, 12 out of 14 hips (86%) healed by non-surgical treatments, while 2 hips (14%) underwent surgical treatments (one case: total hip arthroplasty, and one: anterior rotational osteotomy). On the other hand, in female patients 12 out of 25 (48%) healed, while surgical treatments and/or progression of a collapse were observed in 13 hips (52%) (p < 0.05). Both body mass index and bone mineral density showed no significant difference between male and female SIF patients.
SIF in male is observed mainly in their 40s, and their prognosis seems to be good as compared to that in females.
据报道，股骨头软骨下不全骨折（SIF）主要见于老年骨质疏松女性，并且大多数关于SIF的研究都是基于女性患者开展的。本研究的目的是记录男性患者中SIF的临床特征。
2001年至2011年间，我们科室基于影像学研究和/或组织学检查，连续诊断出39例SIF髋关节病例。其中，14例髋关节（35.8%）为男性SIF患者。对他们的临床放射学特征进行了回顾。
男性SIF患者的年龄范围为16 - 62岁（平均44岁），而女性为22 - 84岁（平均66岁）（p < 0.001）。男性患者中，14例髋关节中有12例（86%）通过非手术治疗愈合，2例髋关节（14%）接受了手术治疗（1例：全髋关节置换术，1例：前路旋转截骨术）。另一方面，女性患者中25例中有12例（48%）愈合，13例髋关节（52%）观察到手术治疗和/或塌陷进展（p < 0.05）。男性和女性SIF患者的体重指数和骨密度均无显著差异。
男性SIF主要见于40多岁，与女性相比，其预后似乎较好。
