Zendeli Afrodite, Bui Minh, Fischer Lukas, Ghasem-Zadeh Ali, Schima Wolfgang, Seeman Ego
Medical Department of Internal Medicine, Rheumatology and Endocrinology at Krankenhaus Herz Jesu, 1030 Vienna, Austria.
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3000, Australia.
J Clin Med. 2021 Mar 8;10(5):1123. doi: 10.3390/jcm10051123.
To determine whether stress fractures are associated with bone microstructural deterioration we quantified distal radial and the unfractured distal tibia using high resolution peripheral quantitative computed tomography in 26 cases with lower limb stress fractures (15 males, 11 females; mean age 37.1 ± 3.1 years) and 62 age-matched healthy controls (24 males, 38 females; mean age 35.0 ± 1.6 years). Relative to controls, in men, at the distal radius, cases had smaller cortical cross sectional area (CSA) ( = 0.012), higher porosity of the outer transitional zone (OTZ) ( = 0.006), inner transitional zone (ITZ) ( = 0.043) and the compact-appearing cortex (CC) ( = 0.023) while trabecular vBMD was lower ( = 0.002). At the distal tibia, cases also had a smaller cortical CSA ( = 0.008). Cortical porosity was not higher, but trabecular vBMD was lower ( = 0.001). Relative to controls, in women, cases had higher distal radial porosity of the OTZ ( = 0.028), ITZ ( = 0.030) not CC ( = 0.054). Trabecular vBMD was lower ( = 0.041). Distal tibial porosity was higher in the OTZ ( = 0.035), ITZ ( = 0.009), not CC. Stress fractures are associated with compromised cortical and trabecular microstructure.
为了确定应力性骨折是否与骨微结构恶化相关，我们使用高分辨率外周定量计算机断层扫描对26例下肢应力性骨折患者（15例男性，11例女性；平均年龄37.1±3.1岁）和62例年龄匹配的健康对照者（24例男性，38例女性；平均年龄35.0±1.6岁）的桡骨远端和未骨折的胫骨远端进行了量化。与对照组相比，在男性中，桡骨远端的病例皮质横截面积（CSA）较小（=0.012），外过渡区（OTZ）（=0.006）、内过渡区（ITZ）（=0.043）和致密外观皮质（CC）的孔隙率较高（=0.023），而小梁骨体积密度（vBMD）较低（=0.002）。在胫骨远端，病例的皮质CSA也较小（=0.008）。皮质孔隙率没有更高，但小梁vBMD较低（=0.001）。与对照组相比，在女性中，病例的桡骨远端OTZ（=0.028）、ITZ（=0.030）的孔隙率较高，CC的孔隙率不高（=0.054）。小梁vBMD较低（=0.041）。胫骨远端OTZ（=0.035）、ITZ（=0.009）的孔隙率较高，CC的孔隙率不高。应力性骨折与皮质和小梁微结构受损有关。
