Guyan Flurina, Waltenspül Manuel, Dietrich Michael, Kabelitz Method
Medical School, University of Zürich, 8006 Zürich, Switzerland.
Clinic for Orthopaedics, Hand Surgery and Trauma Surgery, Stadtspital Zürich, Tièchestrasse 99, 8037 Zürich, Switzerland.
J Clin Med. 2025 Apr 12;14(8):2654. doi: 10.3390/jcm14082654.
Osteoporosis is prevalent in the elderly and increases fracture risk. Bone density is commonly assessed using dual-energy X-ray absorptiometry (DEXA). The femoral cortical thickness index (CTI) also provides indirect information for osteoporosis. It remains unclear whether there are intra-individual differences and if a correlation to fracture risk of the CTI in fractured femora results due to fracture related malrotation during X-rays. The aim of this study was to investigate the individual bilateral CTI in patients with proximal femoral fractures. : A retrospective analysis of 200 surgically treated patients (100 trochanteric, 100 femoral neck fractures) was performed. Measurements included the bilateral CTI at 10 and 15 cm below the lesser trochanter. Analysis of the correlation of those examinations, in comparison to the contralateral CTI at 15 cm, and correlation of the CTI with the body mass index (BMI) and age was performed. : Results showed significant differences ( < 0.001) in bilateral CTIs for both fracture types at 15 cm with a strong inter-rater reliability (ICC > 0.9). There was no significant correlation between age and CTI, as well as BMI and CTI in both cohorts ( > 0.1). Sex-specific subgroup analyses revealed that females exhibited significant differences in CTI between fractured and non-fractured sides ( < 0.001). : In conclusion, CTI, and the modified CTI at 15 cm below the lesser trochanter in fractured proximal femora, is lower compared to the non-fractured side. The femoral CTI could help in daily clinical routines and circumstances, where more detailed risk prediction tools are lacking.
骨质疏松症在老年人中很普遍，会增加骨折风险。骨密度通常使用双能X线吸收法（DEXA）进行评估。股骨皮质厚度指数（CTI）也可为骨质疏松症提供间接信息。目前尚不清楚是否存在个体内差异，以及在X线检查期间，由于骨折相关的旋转不良，骨折股骨的CTI与骨折风险之间是否存在相关性。本研究的目的是调查股骨近端骨折患者的个体双侧CTI。：对200例接受手术治疗的患者（100例转子间骨折，100例股骨颈骨折）进行了回顾性分析。测量包括小转子下方10 cm和15 cm处的双侧CTI。分析了这些检查结果与对侧15 cm处CTI的相关性，以及CTI与体重指数（BMI）和年龄的相关性。：结果显示，两种骨折类型在15 cm处的双侧CTI存在显著差异（<0.001），评分者间可靠性强（ICC>0.9）。在两个队列中，年龄与CTI以及BMI与CTI之间均无显著相关性（>0.1）。按性别进行的亚组分析显示，女性骨折侧与未骨折侧的CTI存在显著差异（<0.001）。：总之，与未骨折侧相比，骨折近端股骨小转子下方15 cm处的CTI及改良CTI较低。在缺乏更详细风险预测工具的日常临床工作和情况下，股骨CTI可能会有所帮助。
