Touloupakis Georgios, Maione Alessio, Lettera Maria Gabriella, Stuflesser Wilfried, Ferrara Fabrizio, Antonini Guido, Crippa Cornelio
Department of Orthopedics and Traumatology, San Carlo Borromeo Hospital, Milan, Italy.
Acta Biomed. 2018 Jun 15;89(2):249-254. doi: 10.23750/abm.v89i2.5660.
The "heart" of the calcar is the internal cortical septum called "femoral thigh spur". Nevertheless, the integrity of the femoral thigh spur and its extensions in Garden I and II femoral neck fractures has not been examined in depth, in CT scan-based studies. The aim of this retrospective study is to analyze characteristics as integrity of upper thigh spur area of the intra-capsular femoral neck using precise CT scans, as well as features of the medial cortical bone interruption of orthopedic calcar, in femoral fractures that are radiographically defined as Garden type I-II.A total number of 23 patients was finally included in our study. We called it the "upper thigh spur area" the area around a 360 degree perimeter of the upper thigh spur. The above-mentioned area is a cylindrical intracapsular structure oriented parallel to the intertrocanteric line of the proximal femur . We analyzed the modification of the cortical bone in this specific intra-capsular area of the femoral neck. In all the cases the upper thigh spur area (the internal cortical septum) was intact. The medial cortical (the known "orthopedic calcar") was evaluated by CT scans in coronal views; it was found to be interrupted in 14 patients and intact in 9; among patients of the first group, 50% were classified as Garden I and 50% as Garden II. The cortical integrity on 360° of the upper thigh spur area was evaluated by CT scans in axial views through different cuts, and it was found to be intact in all cases. More extended studies including CT scans of Garden I-II-III and IV fractures are needed so as to obtain more complete results. In conclusion, it seems that the integrity of the upper thigh spur zone is associated with stable fractures.
股骨矩的“核心”是称为“股骨大粗隆嵴”的内部皮质间隔。然而，在基于CT扫描的研究中，尚未对Garden I型和II型股骨颈骨折中股骨大粗隆嵴及其延伸部分的完整性进行深入研究。本回顾性研究的目的是使用精确的CT扫描分析囊内股骨颈上大腿嵴区域的完整性等特征，以及在X线片上定义为Garden I-II型股骨骨折中矫形股骨矩内侧皮质骨中断的特征。本研究最终纳入了23例患者。我们将围绕股骨大粗隆嵴360度周长的区域称为“上大腿嵴区域”。上述区域是一个与股骨近端粗隆间线平行的圆柱形囊内结构。我们分析了股骨颈这个特定囊内区域皮质骨的改变。在所有病例中，上大腿嵴区域（内部皮质间隔）均完整。通过CT扫描冠状位视图评估内侧皮质（即已知的“矫形股骨矩”）；发现14例中断，9例完整；在第一组患者中，50%分类为Garden I型，50%为Garden II型。通过不同层面的CT扫描轴位视图评估上大腿嵴区域360°的皮质完整性，发现所有病例均完整。需要进行更广泛的研究，包括对Garden I-II-III型和IV型骨折的CT扫描，以获得更完整的结果。总之，上大腿嵴区域的完整性似乎与稳定骨折相关。
