老年髋部骨折后对侧髋部的再骨折

Secondary contralateral hip fractures following hip fractures in the elderly

背景:老年髋部骨折后发生对侧髋部再骨折数目在逐年增加。目的:阐述老年髋部骨折后对侧髋部再骨折的临床特征,提高对再次对侧髋部骨折的认识。方法:于2001-01/2011-07对老年单侧髋部骨折患者567例和老年再发对侧髋部骨折患者30例,分析再发对侧骨折病例的发生率、骨折类型、年龄、性别、骨密度、骨质疏松、再骨折时间间隔和合并症。结果与结论:单侧髋部骨折与再发对侧髋部骨折患者年龄、性别比例和骨密度值接近。老年髋部骨折患者中,对侧髋部再骨折发生率为5.0%。转子间骨折再发对侧髋部骨折率高于股骨颈骨折再发对侧髋部骨折率(P=0.018)。再发对侧骨折组骨质疏松发生率高于单侧骨折组(P=0.032)。初次骨折后发生对侧骨折的间隔时间平均2.4年,其中1年发生的最多,占40.1%。提示老年髋部骨折患者对侧髋部再骨折发生率较高,对于伴有骨质疏松和合并症的转子间骨折患者在术后1年内应加强预防,防止对侧髋部骨折的再次发生。

BACKGROUND： Cases of secondary contralateral hip fractures in old people with hip fractures are increasing every year. OBJECTIVE： To analyze the clinical characteristics of secondary contralateral hip fractures among elderly patient and to improve the understanding of second contralateral hip fractures. METHODS： From January 2001 to July 2011, a total of 567 cases of unilateral hip fractures and 30 cases of secondary contralateral hip fractures in the elderly were selected. The incidence, fractures type, age, gender, bone mineral density, osteoporosis, re-fracture interval, and complications of secondary contralateral hip fractures were analyzed. RESULTS AND CONCLUSION： The age, gender and bone mineral density in the unilateral hip fractures and secondary contralateral hip fractures cases were approximate. The incidence of secondary contralateral hip fracture among the elderly who suffered hip fracture was 5.0%. The rate of the contralateral hip fracture in intertrochanteric fractures was higher than that in the femoral neck fractures （P=0.018）. The incidence of osteoporosis in the secondary contralateral hip fracture group was higher than that in the unilateral fracture group （P=0.032）. The average interval between the two fractures was 2.4 years, with most of secondary contralatera hip fractures occurring within one year, accounting for 40.1%. It is indicated that the incidence of secondary contralatera hip fractures is significantly high in the elderly. For patients who have osteoporosis, a variety of associated complications and intertrochanteric fractures should be strengthened prevention in order to prevent the re-occurrence of hip fracture.