Relation between age, femoral neck cortical stability, and hip fracture risk
Relation between age, femoral neck cortical stability, and hip fracture risk
复制标题
DOI：
10.1016/s0140-6736(05)66870-5
复制
发表时间：
2005-07-09
期刊：
影响因子：
168.9
通讯作者：
Reeve, J
中科院分区：
文献类型：
--
作者：
Mayhew, PM;Thomas, CD;Reeve, J
髋部骨折的风险在60岁以上的老年人中增加了100到1000倍。抗弯曲能力的丧失不是股骨颈正常老化的主要特征。脆性的另一个原因是局部屈曲或弹性不稳定。骨骼适应其局部的机械负荷经验。两足行走可以使负荷不足的上外侧肌变薄。股骨颈皮质是由于行走不能将大量的机械负荷传递到该区域而产生的。我们的目的是测量是否弹性不稳定性随着年龄的增长而大大增加，因为它可能会引发髋部骨折，在一个侧身fall.Methods我们测量了与计算机断层扫描的骨分布在股骨近端77股骨颈的人突然死亡，年龄在20-95岁。然后，我们根据侧向跌倒时载荷最大的皮质区的几何特性和密度计算临界应力，作为弹性不稳定的阈值。结果随着正常衰老，股骨颈上部的这个薄皮质区变得明显更薄。相对于60岁时的平均值，女性皮质厚度每十年下降6.4%（SD 1.1）（p
Background Hip fracture risk rises 100 to 1000-fold over 60 years of ageing. Loss of resistance to bending is not a major feature of normal ageing of the femoral neck. Another cause of fragility is local buckling or elastic instability. Bones adapt to their local experience of mechanical loading. The suggestion that bipedalism allows thinning of the underloaded superolateral. femoral neck cortex arises from the failure of walking to transmit much mechanical load to this region. We aimed to measure whether elastic instability increases greatly with age since it might trigger hip fracture in a sideways fall.Methods We measured with computed tomography the distribution of bone in the mid-femoral neck of 77 proximal femurs from people who died suddenly aged 20-95 years. We then calculated the critical stress, from the geometric properties and density of the cortical zone most highly loaded in a sideways fall, as a threshold for elastic instability.Findings With normal ageing, this thin cortical zone in the upper femoral neck became substantially thinner. Relative to mean values at age 60 years, female cortical thickness declined by 6.4% (SD 1.1) per decade (p