Bell K L, Loveridge N, Power J, Garrahan N, Stanton M, Lunt M, Meggitt B F, Reeve J
Bone Research Group (MRC), Department of Medicine, University of Cambridge, Cambridge, United Kingdom.
J Bone Miner Res. 1999 Jan;14(1):111-9. doi: 10.1359/jbmr.1999.14.1.111.
Although bone mass is a contributory risk factor for hip fracture, its distribution about the femoral neck is also important. Femoral neck biopsies were obtained from 13 females with intracapsular hip fracture (fracture: mean age 74.3 +/- 2.3 years [SEM]) and 19 cadaveric samples (control: 9 males and 10 females 79.4 +/- 1.7 years) and the areas of cortical and cancellous bone were quantitated in octants. In the control group, although males had larger bones than females, the proportions of cortical and cancellous bone were not different (p > 0.05) between the genders. The total amount of bone, as a proportion of bone + marrow, was significantly reduced in the fractures compared with the female controls (%Tt.Ar: fracture 27.83 +/- 1.18, female control 33.62 +/- 1.47; p = 0.0054). Reductions in cortical bone area occurred in all regions but particularly in the inferior, inferoanterior, and anterior octants (p < 0.05). There were no differences between cases and controls in the regional amount of cancellous bone (all regions, p > 0.178). Marked reductions in mean cortical bone width between the fracture and female control group occurred in the anterior, inferoanterior (31%), and superoposterior (25%) regions. Representing cortical widths as simple Fourier functions of the angle about the center of area (R2adj = 0.79) showed in the cases that there was preservation of the cortical bone in the inferior region, with the proportional loss of cortical bone being greatest in the inferoanterior and superoposterior regions. It is concluded that loss of cortical, rather than cancellous, bone predominates in cases of femoral neck fracture. This loss occurs primarily along the inferoanterior to superoposterior axis. As this axis bears the greatest strain during a fall, it is hypothesized that specific thinning of the cortex in these regions leads to an exaggerated propensity to fracture in those so affected, above that resulting from an equivalent general decrease in bone mass.
尽管骨量是髋部骨折的一个促成风险因素，但其在股骨颈周围的分布也很重要。从13例囊内髋部骨折女性患者（骨折组：平均年龄74.3±2.3岁[标准误]）和19份尸体样本（对照组：9例男性和10例女性，年龄79.4±1.7岁）获取股骨颈活检样本，并对皮质骨和松质骨区域进行八分仪定量分析。在对照组中，尽管男性的骨骼比女性大，但皮质骨和松质骨的比例在性别之间并无差异（p>0.05）。与女性对照组相比，骨折组中骨的总量（占骨+骨髓的比例）显著降低（%Tt.Ar：骨折组27.83±1.18，女性对照组33.62±1.47；p = 0.0054）。皮质骨面积在所有区域均减少，尤其是在下、下前和前八分仪区域（p<0.0
