Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, Shijiazhuang, China.
Arch Osteoporos. 2020 Oct 7;15(1):157. doi: 10.1007/s11657-020-00834-0.
Dynamic skeletal deformation with ageing showed important signs of degenerative and osteoporotic diseases. We found that both femoral bowing and cortical thickness were correlated with ageing in a Chinese population. Further, femoral cortical index, an osteoporotic indicator, was negatively correlated with femoral bowing angle. Hence, more attention should be paid to these femoral morphological changes to avoid fragility fractures and failed internal fixation.
The purpose of this study was to determine whether morphological parameters of the femoral shaft are in age-related deformation and identify correlations between parameters of femoral cortical thickness and femoral shaft bowing.
One hundred twenty patients (mean 50 years, range 18~104 years) who had received standard long-standing anteroposterior and femoral lateral radiographs from October 2016 to October 2019 were included in this retrospective study. The sagittal femoral bowing angle (sFBA), sagittal femoral cortical index (sFCI), coronal femoral bowing angle (cFBA), and coronal femoral cortical index (cFCI) were measured by two orthopaedists separately. All the participants' demographic data, including age, sex, body laterality, height, and weight, were collected. The Student's t test, Mann-Whitney U test, two-way ANOVA, Pearson correlation, and multiple linear regression were used in the statistical analysis.
The mean age of the male and female participants was 46.95 ± 15.25 and 52.22 ± 15.61 years, respectively. Two-way ANOVA revealed that females had a significantly lower sFCI than males at the right side (P < 0.05). There were no significant interactions between sex or body laterality and the sFBA, cFBA, sFCI, and cFCI groups (P > 0.05). Pearson correlation revealed that sFCI was strongly correlated with sFBA (r = - 0.535, P < 0.05) and cFBA (r = - 0.535, P < 0.05). Multiple linear regression analysis demonstrated that both age (β = 0.304 and 0.308 respectively) and sFCI (β = - 0.322 and - 0.414 respectively) were two independent predictors associated with sFBA and cFBA respectively.
The femoral shaft bowing of the Chinese population was positively correlated with ageing, whereas the sagittal femoral cortical thickness negatively correlated with ageing. A high FBA occurred in femoral shafts with a low sFCI, which revealed that femoral shaft bowing was associated with femoral cortical thickness. During femur-related surgery in older patients, more attention should be paid to these femoral morphological changes.
本研究旨在确定股骨骨干的形态参数是否存在与年龄相关的变形，并确定股骨皮质厚度参数与股骨骨干弯曲之间的相关性。
本回顾性研究纳入了 2016 年 10 月至 2019 年 10 月期间接受标准前后位和股骨侧位 X 线片的 120 例患者（平均年龄 50 岁，范围 18~104 岁）。由两名骨科医生分别测量矢状面股骨弯曲角度（sFBA）、矢状面股骨皮质指数（sFCI）、冠状面股骨弯曲角度（cFBA）和冠状面股骨皮质指数（cFCI）。收集所有参与者的人口统计学数据，包括年龄、性别、身体侧别、身高和体重。采用 Student's t 检验、Mann-Whitney U 检验、双因素方差分析、Pearson 相关和多元线性回归进行统计学分析。
男性和女性参与者的平均年龄分别为 46.95±15.25 岁和 52.22±15.61 岁。双因素方差分析显示，右侧女性的 sFCI 明显低于男性（P<0.05）。性别或身体侧别与 sFBA、cFBA、sFCI 和 cFCI 组之间无显著交互作用（P>0.05）。Pearson 相关显示，sFCI 与 sFBA（r=-0.535，P<0.05）和 cFBA（r=-0.535，P<0.05）呈强相关性。多元线性回归分析表明，年龄（β=0.304 和 0.308）和 sFCI（β=-0.322 和-0.414）均为 sFBA 和 cFBA 的两个独立预测因子。
中国人的股骨骨干弯曲与年龄呈正相关，而矢状面股骨皮质厚度与年龄呈负相关。股骨骨干弯曲程度高的患者，股骨矢状面皮质厚度较低，这表明股骨骨干弯曲与股骨皮质厚度有关。在老年患者与股骨相关的手术中，应更加注意这些股骨形态变化。
