摘要目的:比较3种不同方式测量老年股骨转子间骨折患者股骨外侧壁厚度的准确性，以期对股骨外侧壁厚度进行精准测量。方法:回顾性分析2023年7月至12月期间首都医科大学附属北京积水潭医院创伤骨科收治的109例老年股骨转子间骨折患者影像学资料。男36例，女73例；年龄（80.3±9.1）岁。对患侧股骨转子部骨折形态进行观察、测量及记录：双侧髋关节正位X线片上患侧股骨转子部是否处于中立位，在双侧髋关节正位X线片、CT平扫图片及CT三维重建图片上测量股骨外侧壁的厚度，比较3种方法的测量结果。结果:术前双侧髋关节正位X线片上股骨转子部处于中立位的图像57例，占52.3%（57/109）。X线片、CT平扫图片、CT三维重建图片上测量的股骨外侧壁厚度分别为（29.02±8.06）、（21.83±8.75）、（31.67±5.92）mm，3种测量方法的测量结果比较差异有统计学意义（ F=47.368， P<0.001），任意两种方法测得的股骨外侧壁厚度比较差异均有统计学意义（ P<0.05）。以CT平扫图片为标准，X线片与CT平扫图片测量股骨外侧壁厚度的组内相关系数为0.376，CT三维重建图片与CT平扫图片测量股骨外侧壁厚度的组内相关系数为0.268，一致性均差。 结论:与双侧髋关节正位X线片、CT三维重建图片相比，CT平扫图片测量股骨外侧壁厚度更为精准，操作可行性更强，对股骨外侧壁厚度的术前评估更具优势。

abstractsObjective:To determine the best accurate measurement of the lateral femur wall in geriatric patients with intertrochanteric fracture by comparing 3 different methods (X-ray, CT axial scan, and CT 3D reconstruction).Methods:A retrospective study was conducted to analyze the imaging data of 109 patients with intertrochanteric fracture of the femur who had been admitted to Beijing Jishuitan Hospital, Capital Medical University from July 2023 to December 2023. There are 36 males and 73 females with an age of (80.3±9.1) years. The morphology of the femoral intertrochanteric fracture on the affected side was observed, measured, and recorded. It was observed whether the affected femoral trochanter was in a neutral position on the anteroposterior X-ray image of bilateral hip joints. The thickness of the lateral femoral wall was measured on X-ray, CT axial scan, and CT 3D reconstruction images of the bilateral hip joints. The measurements were compared between the 3 methods.Results:The affected femoral trochanter was in a neutral position on the anteroposterior X-ray image of bilateral hip joints in 57 cases [52.3% (57/109)]. The thickness of the lateral wall of the femur measured by X-ray was (29.02±8.06) mm, that by axial CT scan (21.83±8.75) mm, and that by CT 3D reconstruction (31.67±5.92) mm, showing statistically significant differences among the 3 methods ( F=47.368, P<0.001). There was a statistically significant difference in the thickness of the lateral wall of the femur between any 2 measurements ( P<0.05). In measurement of the thickness of the lateral femoral wall, based on CT scan images, the intra-group correlation coefficient between X-ray and CT axial scan images was 0.376, and the intra-group correlation coefficient between CT 3D reconstruction and CT axial scan images was 0.268, both showing poor consistency. Conclusions:Compared with X-ray and CT 3D reconstruction images of the bilateral hip joints, measurement of the thickness of the lateral femur wall on CT axial scan images is more accurate and shows strong operational feasibility. Therefore, CT axial scan has advantages in preoperative evaluation of the thickness of the lateral femur wall.