Chai B, Tang X, Tan Z
Shanghai Institute of Traumatology and Orthopaedics.
Zhonghua Wai Ke Za Zhi. 1995 May;33(5):313-5.
Osteoclastic resorption was studied with scanning electron microscope on cross sections of cortical bone of femoral neck collected from 7 aged women with an average age of 72.4 years, who underwent endoprosthetic replacement for intracapsular hip fracture. The cortical bone sections revealed enlargement of the Haversian canals. On the inner linings of the enlarged canals there were many oval-shaped resorption lacunae, reflecting osteoclastic resorption of the Haversian systems. The osteoclastic resorption with subsequent enlargement of the Haversian canals into round or oval cavities took place first over the inner portions of the cortical sections, thereby rendering these areas porotic (cancellization). These processes of the Haversian system and canals then gradually emerged over the central and eventually over the outer areas of the cortical bone, and the entire cortical bone became porotic. In the meanwhile, the inner porotic portion of the cortex turned into trabeculae (trabecularization) and became gradually resorbed, resulting in thinning of the medial cortex. Cortical cancellization, trabecularization and thinning so compromised the material strength of the femoral neck that fracture would ensue even with trivial injury.
对7名平均年龄为72.4岁的老年女性股骨颈皮质骨横断面进行扫描电子显微镜观察,研究破骨细胞吸收情况。这些女性因囊内髋部骨折接受了人工关节置换术。皮质骨切片显示哈弗斯管扩大。在扩大的管腔内衬上有许多椭圆形的吸收陷窝,反映了哈弗斯系统的破骨细胞吸收。破骨细胞吸收并随后使哈弗斯管扩大成圆形或椭圆形腔隙,首先发生在皮质切片的内部,从而使这些区域呈多孔状(松质化)。哈弗斯系统和管腔的这些变化随后逐渐出现在皮质骨的中部,最终出现在外部区域,整个皮质骨都变成了多孔状。与此同时,皮质内部的多孔部分变成小梁(小梁化)并逐渐被吸收,导致内侧皮质变薄。皮质松质化、小梁化和变薄严重损害了股骨颈的材料强度,以至于即使受到轻微损伤也会导致骨折。