Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea.
Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Eur J Trauma Emerg Surg. 2021 Feb;47(1):3-10. doi: 10.1007/s00068-020-01439-5. Epub 2020 Jul 19.
There has been no prior study to demonstrate the relationship between the occurrence of fragility fractures of the pelvis and its morphology. The aim of this study was to investigate the effect of pelvic morphology on fragility fractures of the pelvis caused by low-energy trauma in elderly female patients.
As a normal pelvis group, 643 female patients over 65 years of age who underwent pelvic CT were collected. Using three-dimensional multiplanar reconstruction (3D-MPR) function of RadiAnt software, the DT (diameter of transverse true pelvis)/DS (diameter of sagittal true pelvis) values of normal pelvis were measured. Sorted in ascending order, the mean DT/DS value of normal pelvis was 1.13 ± 0.09. The values corresponding to the 25th percentile and the 75th percentile were 1.06 and 1.18, respectively. We arbitrarily named DT/DS values of 1.06 or less corresponding to lower than 25th percentile as 'Circle types', and DT/DS values of 1.18 or higher corresponding to higher than 75th percentile as 'Ellipse types'. Total of 76 female patients over 65 years of age who underwent 3D reconstructions of pelvic CT scans with fragility fractures of the pelvis, who fell into the criteria corresponding to FFP classification type II, were studied separately. Of the 76 female FFPs, two were FFP type IIa, 32 were FFP type IIb, and 42 were FFP type IIc. Their DT/DS was measured.
Based on the above mentioned criteria, we classified the pelvis shape of 76 patients with fragility fracture of the pelvis type II. 33 patients (43.4%) were classified as circle types and eight patients (10.5%) were classified as ellipse types. The odds ratio of "circle type" for fragility fractures of pelvis type II was 4.1.
With digital reconstruction and 3D measurement of normal adult pelvic CT scans, this study obtained a series of DT/DS values describing the shape of true pelvises. Circle-type true pelvis was found to be more common in patients with fragility fracture of the pelvis type II.
目前尚无研究表明骨盆形态与脆性骨盆骨折的发生有关。本研究旨在探讨老年女性因低能量创伤导致的骨盆脆性骨折与骨盆形态的关系。
选择 643 例年龄在 65 岁以上的女性患者作为正常骨盆组，行骨盆 CT 检查。采用 RadiAnt 软件的三维多平面重建（3D-MPR）功能，测量正常骨盆的 DT（横径真骨盆）/DS（矢状径真骨盆）值。按升序排列，正常骨盆的平均 DT/DS 值为 1.13±0.09。第 25 百分位数和第 75 百分位数对应的数值分别为 1.06 和 1.18。我们将 DT/DS 值等于或小于 1.06 对应于低于第 25 百分位数的命名为“圆形类型”，将 DT/DS 值等于或大于 1.18 对应于高于第 75 百分位数的命名为“椭圆形类型”。共纳入 76 例年龄在 65 岁以上的女性患者，这些患者均行骨盆 CT 三维重建，且患有脆性骨盆骨折，符合 FFP 分类 II 型标准。76 例女性脆性骨盆骨折患者中，FFP Ⅱ a 型 2 例，FFP Ⅱ b 型 32 例，FFP Ⅱ c 型 42 例，分别测量其 DT/DS 值。
根据上述标准，我们将 76 例脆性骨盆骨折 II 型患者的骨盆形状进行分类。33 例（43.4%）为圆形类型，8 例（10.5%）为椭圆形类型。“圆形类型”发生脆性骨盆骨折 II 型的比值比（OR）为 4.1。
通过对成人正常骨盆 CT 扫描进行数字重建和 3D 测量，本研究获得了一系列描述真骨盆形态的 DT/DS 值。圆形真骨盆在脆性骨盆骨折 II 型患者中更为常见。
