Foltin E
Unfallkrankenhaus der AUVA, Linz, Austria.
Arch Orthop Trauma Surg (1978). 1987;106(6):341-8. doi: 10.1007/BF00456867.
Bone loss and fracture type were determined in 358 tibial condylar fractures. Degree of osteoporosis at the knee was defined by analogy to Singh's grades of osteoporosis at the hip and to Jhamaria's classification of osteoporosis at the calcaneum: grade V-normal; grade IV-slight reduction of trabecular bone; grade III-osteoporosis, predominantly of trabecular bone; grade II-osteoporosis of trabecular and cortical bone. Five fracture types were distinguished, with the component of trabecular bone compression increasing from a to e: a-pure split fractures; b-split fractures with displacement of a piece of the articular surface; c-split compression fractures; d-local compression fractures; e-compression of a whole condyle. There was a highly significant rank correlation between the two sets of ordered categories. Fractures in osteoporotics tended to involve the lateral condyle; this is explained by the fact that crush fractures occurred more frequently at the lateral condyle. The influence of bone loss on fracture type was demonstrated to be independent of age. A clear understanding of these associations concerning three variables at a time was reached by the use of log-linear-model analysis for cross-classified qualitative data.
对358例胫骨髁骨折患者的骨质流失情况和骨折类型进行了测定。膝关节骨质疏松程度参照Singh的髋部骨质疏松分级以及Jhamaria的跟骨骨质疏松分类进行定义：V级——正常；IV级——小梁骨轻度减少；III级——骨质疏松，以小梁骨为主；II级——小梁骨和皮质骨均出现骨质疏松。区分出五种骨折类型，小梁骨压缩成分从a到e逐渐增加：a型——单纯劈裂骨折；b型——伴有一块关节面移位的劈裂骨折；c型——劈裂压缩骨折；d型——局部压缩骨折；e型——整个髁的压缩骨折。两组有序类别之间存在高度显著的等级相关性。骨质疏松患者的骨折往往累及外侧髁；这是因为外侧髁更容易发生粉碎性骨折。骨质流失对骨折类型的影响被证明与年龄无关。通过对交叉分类定性数据使用对数线性模型分析，能够同时清晰地了解这三个变量之间的关联。
