Guyan Flurina, Gianduzzo Estelle, Waltenspül Manuel, Dietrich Michael, Kabelitz Method
Clinic for Orthopaedics, Hand Surgery and Trauma Surgery, Stadtspital Zürich, Tièchestrasse 99, 8037 Zürich, Switzerland.
J Clin Med. 2024 Feb 8;13(4):981. doi: 10.3390/jcm13040981.
The cortical thickness index (CTI) is a measure of bone quality and it correlates with the risk of proximal femoral fractures. The purpose of this study was to investigate the CTI in femoral neck, trochanteric fractures and non-fractured femora in geriatric patients and to determine whether there is a correlation between the CTI and the presence of a fracture. : One hundred and fifty patients (fifty femoral neck- (FNFx), fifty trochanteric fractures (TFx) and fifty non-fractured (NFx)) with a mean age of 91 (range 80-104) years were included. Hip radiographs (antero-posterior (ap), lateral) were evaluated retrospectively. Measurements on the proximal femoral inner and outer cortices, including CTI and Dorr's canal calcar ratio (CCR), were assessed for inter-observer reliability (ICC), differences of each fracture and correlation of parameters. : The mean ap CTI on the affected side was 0.43, 0.45 and 0.55 for FNFx, TFx and NFx, respectively. There was a significant difference of the ap CTI and CCR comparing the injured and healthy side for both fracture cohorts ( < 0.001). Patients with FNFx or TFx had significantly lower CTI on both sides compared to the NFx group ( < 0.05). There was no difference for CTI ( = 0.527) or CCR ( = 0.291) when comparing both sides in the NFx group. The mean inter-observer reliability was good to excellent (ICC 0.88). : In proximal femoral fractures, the CTI and CCR are reduced compared with those in non-fractured femora. Both parameters are reliable and show a good correlation in geriatric patients. Therefore, especially for geriatric patients, the CTI and CCR may help to predict fracture risk and consult patients in daily practice.
皮质厚度指数（CTI）是衡量骨质量的指标，与股骨近端骨折风险相关。本研究旨在调查老年患者股骨颈、转子间骨折及未骨折股骨的CTI，并确定CTI与骨折的存在之间是否存在相关性。纳入150例平均年龄为91岁（范围80 - 104岁）的患者（50例股骨颈骨折（FNFx）、50例转子间骨折（TFx）和50例未骨折（NFx））。对髋部X线片（前后位（ap）、侧位）进行回顾性评估。评估股骨近端内外皮质的测量值，包括CTI和多尔管距骨皮质比（CCR）的观察者间可靠性（ICC）、各骨折的差异以及参数的相关性。患侧的平均ap CTI在FNFx、TFx和NFx组中分别为0.43、0.45和0.55。在两个骨折队列中，受伤侧与健康侧的ap CTI和CCR存在显著差异（<0.001）。与NFx组相比，FNFx或TFx患者两侧的CTI均显著降低（<0.05）。在NFx组中比较两侧时，CTI（=0.527）或CCR（=0.291）无差异。观察者间的平均可靠性良好至优秀（ICC 0.88）。在股骨近端骨折中，与未骨折的股骨相比，CTI和CCR降低。这两个参数在老年患者中可靠且显示出良好的相关性。因此，特别是对于老年患者，CTI和CCR可能有助于预测骨折风险并在日常实践中为患者提供咨询。
