不同骨折类型中青年髋部骨折患者骨密度及股骨近端几何参数的差异

doi:10.11958/20260225

天津医药 ›› 2026, Vol. 54 ›› Issue (6): 627-631.doi: 10.11958/20260225

不同骨折类型中青年髋部骨折患者骨密度及股骨近端几何参数的差异

赵丽坤¹^,²(), 崔爽爽¹^,², 于静波¹^,², 孙晓雷³, 张文海⁴, 马信龙¹^,²^,^△()

¹ 天津市天津医院（天津大学天津医院）骨科研究所（邮编300050）
² 天津市骨科生物力学与医学工程重点实验室
³ 天津市天津医院骨密度室
⁴ 骨科

收稿日期:2026-01-20 修回日期:2026-03-12 出版日期:2026-06-15 发布日期:2026-06-15
通讯作者: ^△E-mail：maxinlong8686@sina.com
作者简介:赵丽坤（1989），女，助理研究员，主要从事髋部骨折流行病学与预后方面研究。E-mail：likun09261111@163.com
基金资助:
天津市卫生健康科技项目(TJWJ2022QN055);天津市自然科学基金项目(24JCYBJC01470)

The differences in bone mineral density and proximal femoral geometry between middle-aged and young adult patients with different types of hip fractures

ZHAO Likun¹^,²(), CUI Shuangshuang¹^,², YU Jingbo¹^,², SUN Xiaolei³, ZHANG Wenhai⁴, MA Xinlong¹^,²^,^△()

¹ Tianjin Orthopedic Research Institute, Tianjin Hospital (Tianjin University Tianjin Hospital), Tianjin 300050, China
² Tianjin Key Laboratory of Orthopaedic Biomechanics and Medical Engineering
³ Department of Bone Mineral Density
⁴ Department of Orthopaedics, Tianjin Hospital

Received:2026-01-20 Revised:2026-03-12 Published:2026-06-15 Online:2026-06-15
Contact: ^△E-mail：maxinlong8686@sina.com

赵丽坤, 崔爽爽, 于静波, 孙晓雷, 张文海, 马信龙. 不同骨折类型中青年髋部骨折患者骨密度及股骨近端几何参数的差异[J]. 天津医药, 2026, 54(6): 627-631.

ZHAO Likun, CUI Shuangshuang, YU Jingbo, SUN Xiaolei, ZHANG Wenhai, MA Xinlong. The differences in bone mineral density and proximal femoral geometry between middle-aged and young adult patients with different types of hip fractures[J]. Tianjin Medical Journal, 2026, 54(6): 627-631.

摘要/Abstract

摘要：

目的探究不同类型髋部骨折患者的骨密度（BMD）及股骨近端几何形态差异。方法选取132例年龄在18~50岁的髋部骨折患者，根据骨折部位不同，分为股骨转子间骨折（ITF）组（55例）和股骨颈骨折（FNF）组（77例）。采用倾向性评分匹配（PSM）法对2组患者的年龄与性别进行匹配。比较2组患者的基本资料、BMD及股骨近端几何参数指标差异。结果 PSM前2组患者年龄比较差异无统计学意义。2组均以男性患者居多，但ITF组男性占比更高（P<0.01）。2组患者损伤原因均以低能量损伤为主，且FNF组低能量损伤占比更高（P<0.05）。PSM后，2组股骨颈区、Wards三角区、大粗隆区和全髋区的BMD，总体低骨量发生率差异无统计学意义。2组患者的髋轴长度（HAL）、颈干角（NSA）及曲率比（BR）差异均无统计学意义。但ITF组的横截面积（CSA）、横截面惯性矩（CSMI）及截面模量（SM）大于FNF组（P<0.05）。结论在中青年髋部骨折患者中，ITF患者与FNF患者的BMD没有显著差异，但ITF组患者的骨骼具有更强的抗压缩和抗弯曲性能。

关键词: 髋骨折, 股骨颈骨折, 骨密度, 中青年, 股骨近端几何参数

Abstract:

Objective To compare the differences of bone mineral density (BMD) and proximal femoral geometry between the different types of hip fractures. Methods A total of 132 patients with hip fractures aged 18 to 50 years were selected and divided into the intertrochanteric fracture (ITF) group (n=55) and the femoral neck fracture (FNF) group (n=77) according to different fracture sites. Age and gender were matched in the two groups using propensity score matching (PSM). The basic patient information, BMD and proximal femoral geometry were compared between the two groups. Results There was no significant difference in patient age between the two groups of patients before PSM (P>0.05). Both groups were dominated by male patients, but the proportion of males was higher in the ITF group (P<0.01). Low-energy trauma was the predominant injury mechanism in both groups of patients, and the proportion of low-energy injury was higher in the FNF group (P<0.05). There were no significant differences in BMD of the cervical area, Wards triangle area, greater trochanter area and total hip area between the two groups, and no significant in incidence of overall low bone mass between the two groups (P>0.05). There were no significant differences in hip axial length (HAL), neck-shaft angle (NSA) and buckling ratio (BR) between the two groups. However, the cross-sectional area (CSA), cross-sectional moment of inertia (CSMI) and section modulus (SM) of the ITF group were greater than those of the FNF group (P<0.05). Conclusion In young and middle-aged hip fracture patients, there is no significant difference in BMD between ITF patients and FNF patients. However, the bones of ITF patients have stronger compressive and bending resistance.

Key words: hip fractures, femoral neck fractures, bone density, middle-aged and young adults, proximal femoral geometry

中图分类号:

R683.42

图/表 3

参考文献 37

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组别	n	年龄/岁	性别（男/女）	BMI/ （kg/m²）	损伤原因（低能量/高能量）
FNF组	77	41（35，48）	59/18	22.97±3.26	58/19
ITF组	55	42（36，46）	54/1	24.58±3.96	32/23
t、Z或χ²		0.088	12.101^＊＊	2.559^＊	4.346^＊

组别	n	年龄/岁	性别（男/女）	BMI/ （kg/m²）	损伤原因（低能量/高能量）
FNF组	77	41（35，48）	59/18	22.97±3.26	58/19
ITF组	55	42（36，46）	54/1	24.58±3.96	32/23
t、Z或χ²		0.088	12.101^＊＊	2.559^＊	4.346^＊

组别	n	年龄/岁	性别（男/女）	BMI/ （kg/m²）	损伤原因（低能量/高能量）
FNF组	55	41（34，48）	54/1	23.59±3.32	38/17
ITF组	55	42（36，46）	54/1	24.58±3.96	32/23
t、Z或χ²		0.081	1.000^▲	1.550	1.414

组别	n	年龄/岁	性别（男/女）	BMI/ （kg/m²）	损伤原因（低能量/高能量）
FNF组	55	41（34，48）	54/1	23.59±3.32	38/17
ITF组	55	42（36，46）	54/1	24.58±3.96	32/23
t、Z或χ²		0.081	1.000^▲	1.550	1.414

组别		n	BMD/（g/cm²）								总体骨量
组别		n	股骨颈		Wards三角		大粗隆		全髋		正常		低骨量
FNF组		55	0.79±0.13		0.62±0.13		0.68±0.13		0.80（0.73，0.94）		36		19
ITF组		55	0.84±0.13		0.63±0.13		0.68±0.13		0.84（0.75，0.93）		45		10
t、Z或χ²			1.924		0.406		0.026		0.444		3.793
组别	股骨近端几何参数
组别	HAL/mm			NSA/°		BR		SM/mm³		CSMI/mm⁴		CSA/mm²
FNF组	116.78±6.56			128.56±2.92		8.30±2.45		622.07±150.04		12 780.20±3 284.69		138.76±25.26
ITF组	117.27±6.65			129.40±4.17		7.82±2.74		703.76±176.60		14 419.13±4 191.75		149.42±27.07
t	0.465			1.200		1.011		2.705^＊＊		2.382^＊		2.244^＊

不同骨折类型中青年髋部骨折患者骨密度及股骨近端几何参数的差异

The differences in bone mineral density and proximal femoral geometry between middle-aged and young adult patients with different types of hip fractures

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