Okano T
Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1993 Jan;67(1):71-80.
A histomorphometric analysis was performed to evaluate the cancellous, endocortical envelope and cortical bone obtained at transiliac biopsy in 94 women with hip fracture (39 femoral neck and 55 trochanteric), aged 58-93 (mean 78.1 years), and 21 non-hip fracture women, aged 70-80 (mean 74.6 years), who underwent a bone biopsy during surgery on the hip or knee. In the cancellous envelope, bone volume, trabecular thickness and trabecular number was significantly lower in women with trochanteric fracture compared to the controls. These values were similar in women with femoral neck fracture and the controls. Eroded surface and osteoclast number at the endocortical envelope was significantly higher in both fracture groups than in controls. There were no differences in cortical thickness among the groups. The present study has concluded that trochanteric fracture is associated with low cancellous bone volume characterized by trabecular thinning and loss of trabecular plates and femoral neck fracture is not related with cancellous bone loss. Furthermore, in both fracture groups increased bone resorption at the endocortical envelope appears to be one of the important factors in cortical bone fragility.
对94例髋部骨折女性（39例股骨颈骨折和55例转子间骨折）和21例非髋部骨折女性进行了组织形态计量学分析，以评估经髂骨活检获得的松质骨、骨内膜包壳和皮质骨。94例髋部骨折女性年龄为58 - 93岁（平均78.1岁），21例非髋部骨折女性年龄为70 - 80岁（平均74.6岁），她们在髋部或膝部手术期间接受了骨活检。在松质骨包壳中，与对照组相比，转子间骨折女性的骨体积、小梁厚度和小梁数量显著降低。股骨颈骨折女性和对照组的这些值相似。两个骨折组骨内膜包壳的侵蚀表面和破骨细胞数量均显著高于对照组。各组之间皮质厚度无差异。本研究得出结论，转子间骨折与以小梁变薄和小梁板丢失为特征的低松质骨体积有关，而股骨颈骨折与松质骨丢失无关。此外，在两个骨折组中，骨内膜包壳处骨吸收增加似乎是皮质骨脆性增加的重要因素之一。
