| Objective: Micro-CT(Micro Computed Tomography)was used to compare the structural differences of trabecular bones between steroid-induced femoral head necrosis and femoral neck fracture.Methods: From March 2016 to March 2017,20 cases of femoral neck fractures requiring artificial total hip replacement(20 hips)and 20 cases of steroid-induced femoral head necrosis requiring artificial total hip replacement were collected(20 hips),fracture group and necrosis group,complete removal of femoral head during surgery.Use the computer to carry out three-dimensional reconstruction of the removed femoral head,and use the x,y,and z axes to parallel divide the femoral head from top to bottom,from front to back,from left to right,and divide it into 27 regions,Numbering rules for 27 areas: In the coronal plane,it is divided into three areas: front,middle,and back.Each area is numbered in order from front to back,and from top to bottom.The front zone numbers are A1...A9;the middle zone numbers are B1...B9;the rear group numbers are C1...C9.Scan all samples with Micro-CT to obtain computer three-dimensional images.The area of interest was selected manually,and the bone trabeculae of the femoral head were evaluated by bone volume score,bone trabecular thickness,bone trabecular number,and bone trabecular gap respectively.The t test was used for the comparison between the two groups,and the single factor analysis of variance was used for the comparison between the three groups.Results: In the fracture group,according to the coronal plane,it is divided into anterior,middle and posterior areas,the anterior area shows the dominant bone trabecular area with the largest average bone volume fraction,the largest thickness average,the largest number average,and the smallest gap average,The difference is statistically significant(F=69.50,43.92,85.40,36.00,P values are less than 0.05);The sagittal plane is divided into inside,medial,and lateral areas,the median area is characterized by the largest average bone volume fraction,the largest thickness average,the largest number average,and the smallest gap average,the difference is statistically significant(F=36.59,73.50,38.60,48.50,P values are less than 0.05);According to the cross-section,it is divided into upper,middle and lower zones,the upper zone is characterized by the largest mean bone volume fraction,the largest mean thickness,the largest mean number,and the smallest mean gap,the difference is statistically significant(F=37.03,29.47,255.50,45.50,P values are less than 0.05).Compared with the steroid-induced femoral head necrosis group,if it is divided into medial zone,medial zone,and lateral zone,the median zone appears as the dominant trabecular area(P<0.05);If it is divided into the upper zone,the middle zone,and the lower zone,the upper zone appears as the dominant trabecular region(P<0.05);If the femoral head is divided into an anterior zone,an intermediate zone,and a posterior zone,the anterior zone appears as the dominant trabecular region(P<0.05).Compared with the necrosis group,the average value of trabecular bone volume fraction in each area of the fracture group was larger(t=4.90,P=0.01),the average value of trabecular bone thickness was greater(t=-4.17,P=0.01),the number of trabecular bone was larger(t=-31.37,P=0.01),and the mean value of trabecular bone gap was smaller(t=-7.12,P=0.01).In addition,this study found that the trabecular bones of the anterior superior and anterior superior external areas of the femoral head were prone to fracture through Micro-CT images.Conclusion: The effect of hormones on the necrotic femoral head is not only the necrotic area,including the sclerotic area,the normal trabecular bone area,it has an impact on the entire femoral head. |
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