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目的探讨骨质疏松时股骨颈部位是否存在结构薄弱区。方法股骨颈X片159例,观察由主压力、主张力与次压力骨小梁形成的斜“V”形结构薄弱区。按Singh指数评估骨质疏松程度与结构薄弱区之间的关系。另收集10例股骨干燥标本按横断面、冠状面及矢状面观察内部骨小梁走行及薄弱区特点。部分老年股骨颈骨折三维CT观察股骨颈内部骨小梁走行。结果 Singh 1级(7/159),无“V”形薄弱区;Singh 2级(23/159),V形薄弱区34.78%;Singh 3级(42/159),“V”形薄弱区85.71%;Singh 4级(48/159),“V”形薄弱区75%;Singh 5级(27/159),“V”形薄弱区29.63%;Singh 6级(12/159),无薄弱区。横断面WARD三角底边为不连续主张力骨小梁;冠状面WARD三角形成斜向后外的“V”形薄弱区;矢状位WARD三角底边顶部在股骨颈滋养孔密集区,形成“V”形薄弱区。股骨颈三维CT内部骨小梁走行与干燥骨剖面内部小梁走行一致。结论 Singh 1、2级骨折倾向于头下型。Singh 3、4级骨折倾向于头颈型。Singh 5、6级不易发生股骨颈骨折。
Objective To investigate the existence of structural weak areas in the femoral neck during osteoporosis. Methods 159 cases of X-ray of the femoral neck were observed. The diagonal “V ” structural weak area formed by the main pressure, the main force and the sub-pressure trabecular bone was observed. The Singh Index was used to assess the relationship between the degree of osteoporosis and the area of structural weakness. Another 10 cases of femoral dry specimens were observed by cross-section, coronal and sagittal plane internal trabecular bone walking and weak area characteristics. Three - dimensional CT observation of femoral neck fracture in elderly patients. Results Singh grade 1 (7/159), no “V” shaped weak area; Singh grade 2 (23/159), V-shaped weak area 34.78%; Singh grade 3 (42/159), “V” (85/151), Singh Grade 4 (48/159), V- shaped weak area 75%, Singh Grade 5 (27/159), V- shaped weak area 29.63%, Singh Grade 6 12/159), weak areas. The bottom of the WARD triangular cross-section is the discontinuous main tension trabeculae; the coronal WARD triangle forms the “V” shaped weak area obliquely outwards; the top of the sagittal WARD triangle base is located in the densely nourished hole of the femoral neck, Form a “V” shaped weak area. The trabecular bone traverses in the three-dimensional CT of the femoral neck are consistent with those of the trabecular bone in the dry bone cross-section. Conclusion Singh fractures of grade 1 and 2 tend to be subdural. Singh fractures tend to head and neck grade 3,4. Singh 5,6 hard to occur femoral neck fracture.