摘要
在１４例有明确骨质疏松症的股骨颈骨折病人（女７例，平均年龄为７２．４岁，男７例，平均年龄为７０．８岁）进行人工股骨头置换手术时，取下股骨头。在关节软骨下部位及骨折边缘部位，取松质骨作透射电镜观察。并取３例因交通事故死亡的正常年轻成年人股骨头、颈的相应部位标本作对照。对照标本松质骨的骨细胞处于成骨相及吸收相。老年骨折病人股骨上端松质骨的骨细胞则处于吸收相与退变相。细胞器不断减少，核固缩、细胞裂解、死亡；留下空陷窝。陷窝及骨小管四周骨基质降解，陷窝及骨小管扩大。陷窝及骨小管边缘出现嗜锇板层。陷窝内充满絮状物质。空陷窝可汇合成为较大的空腔。因之股骨头、颈松质骨的结构强度明显下降，在轻微暴力面前，易罹骨折。
The femoral heads were collected from 14 cases of endoprosthetic replacement for fracture of femoral neck with established osteoporosis. There were 7 females with an average age of 72.4 years and 7 males with an average age of 70.8 years. The cancellous bone tissues were harvested from both the subchondral area and the fracture margin and processed for transmission electron microscopic observation. Cancellous bone tissues were also taken from corresponding areas of upper femur of 3 normal young adults died of traffic accident and served as control. The osteocytes of the cancellous bone tissues of the control specimens belonged to formative and resorptive phase osteocytes. However, the osteocytes of the elderly and osteoporotic specimens reprensented resorptive and degenerative ones. Here, the organelle in the cytoplasm decreased gradually, nucleus showed pyknotic changes, and then the cells died and disntegrated, leaving behind empty lacunae. There was degradation of the bone matrices of the lacunae and canaliculi, which then became enlarged. Osmiophilic lamina appeared along the lacunae and canaliculi, which were also filled up with flocculent materials. The empty lacunae could coalesce with one another and fuse together to form larger spaces. Consequently, the structural strength of the cancellous bone tissues of the upper femur declined markedly and even a trifle of external violence would suffice to cause a fracture.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1997年第11期689-692,I001,共5页
Chinese Journal of Orthopaedics
