Kannus P, Järvinen M, Sievänen H, Järvinen T A, Oja P, Vuori I
UKK Institute for Health Promotion Research, Tampere, Finland.
J Bone Miner Res. 1994 Nov;9(11):1729-36. doi: 10.1002/jbmr.5650091109.
This study determined the areal bone mineral density (BMD) from the lumbar spine (L2-4), right distal radius and ulna, and the femoral neck, trochanter area of the femur, distal femur, patella, proximal tibia, and calcaneus of both extremities in 29 men who had a femur shaft fracture 10 years earlier. For evaluation of the patients' BMDs in the spine and distal forearm, 29 age-, weight-, and height-matched normal men were also measured. Compared with normal men (mean +/- SD = 1.123 +/- 0.153), the spinal BMDs of the patients were significantly (p = 0.0054) lower (1.018 +/- 0.119, -9.3%). Distal radius and distal ulna showed no significant group differences. In patients, the mean BMD of the injured extremity (compared with the uninjured side) was significantly lower in the distal femur (-6.8%; p = 0.0000), patella (-5.4%; p = 0.0000), proximal tibia (-4.7%; p = 0.0000), and calcaneus (-2.2%; p = 0.0259). In the proximal femur, this value was at the same level (femoral neck 1.3%, NS) or higher (trochanter area 6.3%, p = 0.0002) than that in the uninjured extremity. The relative BMDs of the injured extremity did not associate with the fracture type, fracture location, age, muscle strength, follow-up time, or non-weight-bearing time but showed significant (r = 0.33-0.64) positive correlation with low pain assessment and high functional scores of the injured extremity.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究测定了29名10年前发生股骨干骨折男性患者双侧腰椎(L2 - 4)、右桡骨远端和尺骨远端、股骨颈、股骨转子区、股骨远端、髌骨、胫骨近端以及跟骨的骨面积密度(BMD)。为评估患者脊柱和前臂远端的骨密度,还测量了29名年龄、体重和身高匹配的正常男性。与正常男性(均值±标准差 = 1.123±0.153)相比,患者的脊柱骨密度显著降低(1.018±0.119,降低9.3%,p = 0.0054)。桡骨远端和尺骨远端未显示出显著的组间差异。在患者中,伤侧下肢的平均骨密度在股骨远端(降低6.8%;p = 0.0000)、髌骨(降低5.4%;p = 0.0000)、胫骨近端(降低4.7%;p = 0.0000)和跟骨(降低2.2%;p = 0.0259)显著低于健侧。在股骨近端,该值与健侧处于相同水平(股骨颈1.3%,无显著性差异)或更高(转子区6.3%,p = 0.0002)。伤侧下肢的相对骨密度与骨折类型、骨折部位、年龄、肌肉力量、随访时间或非负重时间无关,但与伤侧下肢的低疼痛评估和高功能评分呈显著正相关(r = 0.33 - 0.64)。(摘要截选至250字)