Bone and muscle mass after femoral neck fracture. A controlled quantitative computed tomography study of osteosynthesis versus primary total hip arthroplasty
| Autor: | Per Adolphson, Nils Dalén, Mats Dahlborn, Gustaf Neander, K von Sivers |
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| Rok vydání: | 1997 |
| Předmět: |
musculoskeletal diseases
Male medicine.medical_specialty Arthroplasty Replacement Hip Thigh Fracture Fixation Internal Bone Density medicine Humans Orthopedics and Sports Medicine Femur Quantitative computed tomography Muscle Skeletal Femoral neck Aged Aged 80 and over Osteosynthesis medicine.diagnostic_test business.industry General Medicine musculoskeletal system medicine.disease Surgery Femoral Neck Fractures Osteopenia Bone Diseases Metabolic medicine.anatomical_structure Harris Hip Score Cortical bone Female business Tomography X-Ray Computed |
| Zdroj: | Archives of orthopaedic and trauma surgery. 116(8) |
| ISSN: | 0936-8051 |
| Popis: | The cortical bone mineral density (BMD), bone volume, bone mass and muscle volume of the thigh, and the BMD of the distal femur and proximal tibia were measured quantified by quantitative computed tomography (QCT) after an operation for a displaced femoral neck fracture. Twenty patients were randomized to osteosynthesis or total hip arthroplasty (THA). Both legs were scanned after 18 months, and the operated side was compared with the healthy side. Clinical assessment was performed with a Harris hip score. A reference group of 9 patients, who had undergone THA because of arthrosis, was chosen. In the fracture patients, we found a 9% decrease in bone mass and muscle volume of the middle femur. The BMD of the distal femur and proximal tibia showed a more marked osteopenia. There was no difference in these parameters between the two groups. In the reference group of operated arthrosis patients, we did not find any differences between sides postoperatively. After the operation, the fracture patients had a lower Harris score than the arthrosis patients, and this was most pronounced among those who had undergone osteosynthesis. The finding of a marked osteopenia after a femoral neck fracture, irrespective of treatment, but no bone loss after THA because of arthrosis, implies that patients with a femoral neck fracture are more sensitive to osteopenia, and that the bone loss is not proportional to the operative trauma. caused by the disuse and the posttraumatic effect on the bone caused by the operation. Also, the magnitude of the operative trauma may play a role in the development of the osteopenia. Thus, a displaced femoral neck fracture, treated with osteosynthesis or total hip arthroplasty (THA), offers a possibility to distinguish between the osteopenia caused by the fracture and the role of the operation, since the degree of the operative trauma is different. The aim of this study was to investigate whether or not the bone loss after a displaced femoral neck fracture depends on the mode of treatment. |
| Databáze: | OpenAIRE |
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