65세 이상의 여성에서 발생한 대퇴 경부 골절과 전자간부 골절 환자 간의 골밀도 및 골 구조 비교 = Comparison of Femoral Morphology and Bone Mineral Density between Femoral Neck Fractures and Trochanteric Fractures in 65+ Females

국문 초록 (Abstract)

목적: 65세 이상의 여성에서 발생한 대퇴 경부 골절 및 전자간부 골절 환자 간의 골밀도 및 골 구조에 대하여 방사선학적 결과를 분석하였다. 대상 및 방법: 2008년 4월부터 2011년 3월까지 대퇴 경부 골절 및 전자간부 골절로 내원하여 골밀도 검사 및 전산화 단층 검사를 시행한 65세 이상 여성, 125명을 대상으로 하였다. 골밀도는 이중 에너지 방사선 흡수 측정법으로 측정하였으며, 골 구조는 전산화 단층 촬영을 통해 건측 고관절의 형태를 측정하였다. 결과: 대퇴 경부 골절군에서의 대퇴 경부 및 전자부 골밀도 평균치는 0.563 g/cm2와 0.753 g/cm2, 대퇴 전자간 골절군에서는 0.457 g/cm2와 0.656 g/cm2로 나타나 전자간 골절군에서 통계학적으로 유의하게 낮게 측정되었다(P=0.029, 0.030). 대퇴 경부 골절군에서 피질골 지수의 평균치가 0.59, 대퇴 전자간 골절군에서는 0.51로 나타나 각각 대퇴 전자간 골절군에서 통계학적으로 유의하게 낮게 측정되었다(P=0.001). 결론: 대퇴 전자간 골절군에서 경부 골절군에 비해 낮은 골밀도 소견을 보였고 대퇴골이 얇은 피질골소견을 보였다. 65세 이상 근위 대퇴 골절 여성에 있어서 골밀도 측정 및 전산화 단층 촬영은 유용한 검사라 생각한다.

다국어 초록 (Multilingual Abstract)

Purpose: To analyze, by radiograph, the difference in bone mineral density (BMD) and the proximal femoral morphology of females who are over 65 years old and have had either an intertrochanteric fracture or a femoral neck fracture. Material and Methods: One hundred twenty-five females over 65 years of age with femoral neck fractures or intertrochanteric fractures were examined for bone mineral density using computed tomography from April 2008 to March 2011. The bone mineral density was measured by dual-energy x-ray absorptiometry (DEXA). The morphology of the proximal femur was also measured by computed tomography in the unaffected hip. Results: In the femoral neck fracture group, the mean BMD value was 0.563 g/cm2 in the femoral neck region and 0.753 g/cm2 in the intertrochanteric region. In the intertrochanteric fracture group, the mean BMD value was 0.457 g/cm2 in the femoral neck region and 0.656 g/cm2 in the intertrochanteric region. There are statistically significant differences between the femoral neck fracture and intertrochanteric fracture groups (P=0.029, 0.030). The mean cortical index was 0.59 in the femoral neck fracture group and 0.51 in the intertrochanteric fracture group. There are statistical differences between the femoral neck fracture and intertrochanteric fracture groups (P=0.001). Conclusion: The BMD of the proximal femoral neck and intertrochanteric regions of the intertrochanteric fracture group were significantly lower than that of the femoral neck fracture group. The cortical index was also significantly lower in the intertrochanteric fracture group than the femoral neck fracture group. BMD and computed tomography seem useful to check in women older than 65 who have fractures of the proximal femur.

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