肩、肘、腕部骨折患者的社会学特点及相关风险因素分析

The analysis of risk factors and social characteristics for patients with fractures in the shoulder,the elbow,or the wrist

目的研究北京大学人民医院创伤骨科自1999年1月至2008年5月期间,手术治疗的375例肩、肘及腕部骨折患者的社会学特点并分析相关风险因素。方法通过对患者临床病历回顾性调查,调研了上述三组骨折患者的基本资料、致伤因素及临床特点、社会学特点;统计和分析了患者的基本资料、患者的生活状况、创伤特点、交通伤的流行病学特点及其多种风险因素之间的相关性。统计分析在SPSS下完成,以P<0.05作为显著性差异。结果肩、腕部骨折以老年性骨质疏松性骨折为主,女性患者居多,其发生原因多为摔伤等低能量损伤;肘部骨折以中年患者为主,男女患者比例相当,其发生原因多为高能量损伤;肘部患者的住院时间与患者的年龄有明显关系;腕部骨折的患者住院时间最短;交通伤明显增加患者的住院时间;引起损伤的撞击能量高、低,患者的付款方式,是否有合并症等诸因素对患者的住院时间没有明显影响。结论肩、肘、腕部骨折患者的社会学特点与其受伤的部位、方式、程度有相关性,并对指导诊疗有一定的帮助,应根据骨折发生的风险因素进行相应的预防。

Objective To study the social characteristics and relative risk factors of 375 postoperative patients with fractures in the shoulder, the elbow, or the wrist, who were operated in the Department of Orthopedics and Trauma, People＇s Hospital of Peking University from January 1999 to May 2008. Methods Retrospective study methods were used to investigate the fracture patients in above three groups： including basic patient information, trauma, clinic and social characteristics, and to analyze statistically the correlation among the patient basic information, living status, trauma, traffic accident, and epidemiological characteristics. Statistical analysis was performed using SPSS software. P value less than 0. 05 was considered to be significantly different. Results The fractures in the shoulder and the wrist mostly occurred in the elderly people with osteoporosis, especially in the elderly women, due to the impact of low energy such as falling. The fractures in the elbow mostly occurred in the middle-aged men, with equal ratio of the male and female, due to the impact of high energy. There was a obvious relationship between hospitalization time and the age of patients. The longest hospitalization time occurred in patients with wrist fractures. Traffic accidence clearly increased the patient hospitalization time. High or low energy injury, payment modes, and with or without complications did not obviously affect on the hospitalization time of the patients. Conclusion There is correlation between the social characteristics of patients with fractures in the shoulder, the elbow, or the wrist and the location, type, and degree of the injury. This will help to guide the diagnosis and treatment of osteoporosis, and to prevent the bone from fracture according to the risk factors.