目的 探讨伤后腕关节正位X线影像测量桡骨远端骨皮质厚度的可行性、桡骨远端骨皮质厚度与髋部及腰椎骨密度之间的关系以及评估桡骨远端骨皮质厚度预测骨质疏松症的能力。方法 对91例年龄≥50岁经X线确诊为桡骨远端骨折的患者行双能X线...目的 探讨伤后腕关节正位X线影像测量桡骨远端骨皮质厚度的可行性、桡骨远端骨皮质厚度与髋部及腰椎骨密度之间的关系以及评估桡骨远端骨皮质厚度预测骨质疏松症的能力。方法 对91例年龄≥50岁经X线确诊为桡骨远端骨折的患者行双能X线吸收检测法(dual energy X-ray absorptiometry,DXA)测定,根据 T 值分为两组:骨质疏松组55例,男性6例,女性49例,年龄52~83(63.5±8.2)岁,体质量 46~ 88(57.2±8.1)kg,体质量指数(body mass index,BMI)(24.3±3.0)kg/m^2;非骨质疏松组36例,男性2例,女性34例,年龄50~69(57.9±6.1)岁,体质量42.5~80.0(62.5±8.7)kg, BMI(25.5±3.3)kg/m^2。通过医学影像信息系统(picture archiving and communication systems,PACS),在腕关节正位X线影像上,于距离尺骨远端关节面40、60 mm处测量桡骨远端双侧骨皮质厚度。结果 骨质疏松组患者较非骨质疏松组年龄大、体质量轻,且桡骨远端骨皮质厚度较非骨质疏松组薄,骨皮质比率较非骨质疏松组低,差异有统计学意义( P <0.01);两组患者BMI差异无统计学意义( P >0.01)。桡骨远端骨皮质厚度与髋部骨密度正相关( r = 0.309, P =0.000),与腰椎骨密度正相关( r =0.445, P =0.000)。一元线性回归分析表明:桡骨远端骨皮质厚度每增加 1 mm ,髋部骨密度值增加0.071 g/cm^2( R^2=0.230, P =0.000),腰椎骨密度值增加0.065 g/cm^2 ( R^2= 0.265, P =0.000)。桡骨远端骨皮质厚度5.2 mm为诊断骨质疏松最佳诊断临界点,其敏感度80.4%、特异度69.4%、阴性预测值69.4%,曲线下面积为0.749。结论 桡骨远端骨皮质厚度与髋部及腰椎骨密度正相关,桡骨远端骨皮质变薄与骨质疏松相关,通过X线检查测量桡骨远端骨皮质厚度快速简便,可初步筛查骨量减少,并提示进一步行骨密度检查。展开更多
Bone graft may be needed to fill bone defect in elderly patients with a metaphyseal comminuted distal radius fracture. In this retrospective, nonrandomized, single-surgeon study, we evaluated the clinical and radiolog...Bone graft may be needed to fill bone defect in elderly patients with a metaphyseal comminuted distal radius fracture. In this retrospective, nonrandomized, single-surgeon study, we evaluated the clinical and radiologic outcomes of using both dorsal locking plates with or without augmentation with mineralized collagen （MC） bone graft for elderly patients with dorsally metaphyseal comminuted radius fractures. Patients in group 1 （n = 12） were treated with dorsal locking plates with MC bone graft application into the metaphyseal bone defect, and those in group 2 （n - 12） only with dorsal locking plates. Clinical and radiologic parameters were determined at three and 12 months after surgery. At final follow-up, no significant difference was noted between the 2 groups in terms of palmar tilt and radial inclination （p - 0.80）; however, ulnar variance increased significantly in the group 2 treated with dorsal locking plates without augmentation （p〈0.05）. Functionally, there was no significant difference between the groups. Our preliminary study suggests that combination of MC as bone-graft substitutes and dorsal locking plates may be a usefully alternative for elderly patients with metaphyseal comminuted distal radius fracture.展开更多
文摘目的 探讨伤后腕关节正位X线影像测量桡骨远端骨皮质厚度的可行性、桡骨远端骨皮质厚度与髋部及腰椎骨密度之间的关系以及评估桡骨远端骨皮质厚度预测骨质疏松症的能力。方法 对91例年龄≥50岁经X线确诊为桡骨远端骨折的患者行双能X线吸收检测法(dual energy X-ray absorptiometry,DXA)测定,根据 T 值分为两组:骨质疏松组55例,男性6例,女性49例,年龄52~83(63.5±8.2)岁,体质量 46~ 88(57.2±8.1)kg,体质量指数(body mass index,BMI)(24.3±3.0)kg/m^2;非骨质疏松组36例,男性2例,女性34例,年龄50~69(57.9±6.1)岁,体质量42.5~80.0(62.5±8.7)kg, BMI(25.5±3.3)kg/m^2。通过医学影像信息系统(picture archiving and communication systems,PACS),在腕关节正位X线影像上,于距离尺骨远端关节面40、60 mm处测量桡骨远端双侧骨皮质厚度。结果 骨质疏松组患者较非骨质疏松组年龄大、体质量轻,且桡骨远端骨皮质厚度较非骨质疏松组薄,骨皮质比率较非骨质疏松组低,差异有统计学意义( P <0.01);两组患者BMI差异无统计学意义( P >0.01)。桡骨远端骨皮质厚度与髋部骨密度正相关( r = 0.309, P =0.000),与腰椎骨密度正相关( r =0.445, P =0.000)。一元线性回归分析表明:桡骨远端骨皮质厚度每增加 1 mm ,髋部骨密度值增加0.071 g/cm^2( R^2=0.230, P =0.000),腰椎骨密度值增加0.065 g/cm^2 ( R^2= 0.265, P =0.000)。桡骨远端骨皮质厚度5.2 mm为诊断骨质疏松最佳诊断临界点,其敏感度80.4%、特异度69.4%、阴性预测值69.4%,曲线下面积为0.749。结论 桡骨远端骨皮质厚度与髋部及腰椎骨密度正相关,桡骨远端骨皮质变薄与骨质疏松相关,通过X线检查测量桡骨远端骨皮质厚度快速简便,可初步筛查骨量减少,并提示进一步行骨密度检查。
文摘Bone graft may be needed to fill bone defect in elderly patients with a metaphyseal comminuted distal radius fracture. In this retrospective, nonrandomized, single-surgeon study, we evaluated the clinical and radiologic outcomes of using both dorsal locking plates with or without augmentation with mineralized collagen （MC） bone graft for elderly patients with dorsally metaphyseal comminuted radius fractures. Patients in group 1 （n = 12） were treated with dorsal locking plates with MC bone graft application into the metaphyseal bone defect, and those in group 2 （n - 12） only with dorsal locking plates. Clinical and radiologic parameters were determined at three and 12 months after surgery. At final follow-up, no significant difference was noted between the 2 groups in terms of palmar tilt and radial inclination （p - 0.80）; however, ulnar variance increased significantly in the group 2 treated with dorsal locking plates without augmentation （p〈0.05）. Functionally, there was no significant difference between the groups. Our preliminary study suggests that combination of MC as bone-graft substitutes and dorsal locking plates may be a usefully alternative for elderly patients with metaphyseal comminuted distal radius fracture.
