Assessment of the strength of proximal femur in vitro: Relationship to femoral bone mineral density and femoral geometry
Assessment of the strength of proximal femur in vitro: Relationship to femoral bone mineral density and femoral geometry
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DOI：
10.1016/s8756-3282(96)00383-3
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发表时间：
1997-03-01
期刊：
影响因子：
4.1
通讯作者：
Dequeker, J
中科院分区：
文献类型：
--
作者：
Cheng, XG;Lowet, G;Dequeker, J
在64具尸体右侧股骨近端X线片上测量了股骨颈轴长、颈宽和颈干角（28名女性，36名男性），使用双能X射线吸收测定法（DXA）测量不同感兴趣区域的骨矿物质密度（BMD），定量计算机断层扫描（QCT）用于测定股骨转子和股骨颈处皮质骨和松质骨的BMD和骨面积，通过模拟在大转子上跌倒的力学测试确定股骨的强度，随后通过X线片确定骨折类型（颈椎或转子）。观察到26例颈椎骨折和38例转子骨折，骨折类型分布无显著性别差异，男性股骨强度显著高于女性，DXA转子BMD更强（p < 0.05）与股骨强度的相关性（r（2）= 0.88）高于任何其他DXA BMD测量值（r（2）= 0.59-0.76）。在多元回归模型中，不同DXA BMD测量的组合仅产生了股骨强度解释变异性的小幅增加（1%），在QCT测量中，转子皮质面积与股骨强度产生了最佳相关性（r（2）= 0.83），弱，但显著，股骨强度与股骨粗隆区（r（2）= 0.28）和股骨颈区（r（2）= 0.07）皮质骨密度相关。在多元回归模型中，结合QCT参数得到的r（2）最多为0.87。几何参数中，颈轴长和颈宽与股骨强度显著相关（r（2）分别为0.24，0.22），但强度与颈干角之间没有显著相关性。DXA股骨粗隆BMD与股骨颈宽度的联合测量仅比单独测量股骨粗隆BMD的解释变异性增加了1%。结果表明，DXA和QCT在体外预测股骨强度方面具有相似的能力，股骨粗隆BMD是最好的DXA参数，和皮质面积（非皮质BMD）是最佳QCT参数，股骨近端的几何测量与机械强度仅弱相关，与单独使用单个解释变量相比，DXA、QCT和几何参数的组合仅导致预测能力的小幅增加。(C)Elsevier Science Inc.出版。
Femoral neck axis length, neck width, and neck-shaft angle mere measured on radiographs of right proximal femora from 64 cadavers (28 female, 36 male), Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry (DXA) for various regions of interest, and quantitative computed tomography (QCT) was used to determine BMD and bone areas for cortical and trabecular bone at the trochanter and femoral neck, The strength of the femur was determined by a mechanical test simulating a fall on the greater trochanter, and the fracture type (cervical or trochanteric) was subsequently determined from radiographs. Twenty-six cervical fractures and 38 trochanteric fractures were observed, with no significant sex difference in the distribution of fracture types, Femoral strength was significantly elevated in males compared to females, DXA trochanteric BMD was more strongly (p < 0.05) correlated with femoral strength (r(2) = 0.88) than were any of the other DXA BMD measurements (r(2) = 0.59-0.76), In multiple regression models, a combination of different DXA BMD measurements produced only a small increase (1%) in the explained variability of femoral strength, Of the QCT measurements, trochanteric cortical area yielded the optimal correlation with femoral strength (r(2) = 0.83), Weak, but significant, correlations were observed between femoral strength and cortical BMD at trochanteric (r(2) = 0.28) and neck regions (r(2) = 0.07). In multiple regression models, combining QCT parameters yielded, at best, an r(2) Of 0.87, Of the geometrical parameters, both neck axis length and neck width were significantly correlated with femoral strength (r(2) = 0.24, 0.22, respectively), but no significant correlation was found between strength and the neck shaft angle, Combining DXA trochanteric BMD with femoral neck width resulted in only a small increase in the explained variability (1%) compared to trochanteric BMD alone, The results demonstrated that DXA and QCT had a similar ability to predict femoral strength in vitro, Trochanteric BMD was the best DXA parameter, and cortical area (not cortical BMD) was the optimal QCT parameter, Geometric measurements of the proximal femur were only weakly correlated with the mechanical strength, and combinations of DXA, QCT, and geometric parameters resulted in only small increases in predictive power compared to the use of a single explanatory variable alone.(C) 1997 by Elsevier Science Inc.