Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea.
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Biomed Res Int. 2017;2017:5932496. doi: 10.1155/2017/5932496. Epub 2017 Mar 28.
The purpose of our study was to investigate the radiographic characteristics of atypical femoral shaft fractures (AFSFs) in females with a particular focus on femoral bow and cortical thickness. We performed a fracture location-, age-, gender-, and ethnicity-matched case-control study. Forty-two AFSFs in 29 patients and 22 typical osteoporotic femoral shaft fractures in 22 patients were enrolled in AFSF group and control group, respectively. With comparing demographics between two groups, radiographically measured femoral bow and cortical thicknesses of AFSF group were compared with control group. All AFSF patients were females with a mean age of 74.4 years (range, 58-85 years). All had a history of bisphosphonate (BP) use with a mean duration of 7.3 years (range 1-17 years). Femoral bow of AFSF group was significantly higher than control group on both anteroposterior (AP) and lateral radiographs after age correction. Mean femoral bow on an AP radiograph was 12.39° ± 5.38° in AFSF group and 3.97 ± 3.62° in control group ( < 0.0001). Mean femoral bow on the lateral radiograph was 15.71° ± 5.62° in AFSF group and 10.72° ± 4.61° in control group (after age correction = 0.003). And cortical thicknesses of AFSF group demonstrated marked disparity between tensile and compressive side of bowed femurs in this study. An adjusted lateral cortical thickness was 10.5 ± 1.4 mm in AFSF group and 8.1 ± 1.3 mm in control group (after age correction < 0.0001) while medial cortical thickness of AFSF group was not statistically different from control group. Correlation analysis showed that the lateral femoral bow on the AP radiograph was solely related to lateral CTI ( = 0.378, = 0.002). AFSFs in female BP users were associated with an increased anterolateral femoral bow and a thicker lateral cortex of femurs.
我们的研究目的是探讨女性非典型股骨骨折（AFSFs）的影像学特征，特别关注股骨弯曲和皮质厚度。我们进行了一项骨折部位、年龄、性别和种族匹配的病例对照研究。42 例 AFSF 患者（29 例）和 22 例典型骨质疏松性股骨骨折患者（22 例）纳入 AFSF 组和对照组。比较两组患者的一般资料后，比较 AFSF 组和对照组的股骨弯曲和皮质厚度。所有 AFSF 患者均为女性，平均年龄 74.4 岁（58-85 岁）。所有患者均有双膦酸盐（BP）使用史，平均使用时间为 7.3 年（1-17 年）。校正年龄后，AFSF 组在前后位（AP）和侧位 X 线片上的股骨弯曲均明显高于对照组。AP 位 X 线片上 AFSF 组的平均股骨弯曲为 12.39°±5.38°，对照组为 3.97°±3.62°（<0.0001）。侧位 X 线片上 AFSF 组的平均股骨弯曲为 15.71°±5.62°，对照组为 10.72°±4.61°（校正年龄后 = 0.003）。本研究中，AFSF 组弯曲股骨的拉伸侧和压缩侧皮质厚度存在明显差异。AFSF 组的调整后外侧皮质厚度为 10.5±1.4mm，对照组为 8.1±1.3mm（校正年龄后 <0.0001），而 AFSF 组的内侧皮质厚度与对照组无统计学差异。相关性分析显示，AP 位 X 线片上的外侧股骨弯曲仅与外侧 CTI 相关（ = 0.378， = 0.002）。女性 BP 使用者的 AFSF 与前外侧股骨弯曲增加和股骨外侧皮质增厚有关。
