2003年至2012年河北医科大学第三医院成人距骨合并同侧踝关节骨折的流行病学分析

Epidemiological survey of talar combined with ipsilateral ankle fractures in the Third Affiliated Hospital to Hebei Medical University from 2003 through 2012

目的 分析10年期间河北医科大学第三医院成人距骨合并同侧踝关节骨折的流行病学特征及变化趋势.方法 对2003年1月至2012年12月河北医科大学第三医院收治的成人距骨合并同侧踝关节骨折患者资料进行回顾性分析,记录患者的性别、年龄及骨折AO分型等数据,将全部距骨骨折的患者资料定为A组,距骨合并骨折的患者资料定为B组,距骨合并同侧踝关节骨折的患者资料定为C组,对3组及C组前、后5年收治的患者资料进行对比分析,总结出10年期间成人距骨合并同侧踝关节骨折的流行病学特征及变化趋势.结果 共收集158例C组患者,占同期B组患者的52.15％ （158/303）,占同期A组患者的27.77％ （158/569）,其中21 ～30岁构成比最高（32.28％,51/158）;A、C组性别、年龄构成比差异均无统计学意义（χ^2=2.564,P=0.109;χ^2=5.970,P=0.309）,C组距骨复杂骨折所占比率高于A组（χ^2=7.105,P=0.008）;C组中前、后5年患者的性别、年龄构成对比差异均无统计学意义（χ^2=0.722,P=0.395;χ^2=5.493,P=0.359）;C组占B组比率前、后5年间对比差异无统计学意义（χ^2=0.232,P=0.630）;C组中81-B型合并44-A2组骨折构成比最高（32.91％）,其占C组的比率前、后5年间比较差异无统计学意义（χ^2=2.912,P=0.088）;C组中距骨骨折各类型所占比率前、后5年对比差异均无统计学意义（P＞0.05）.结论 10年期间成人距骨合并同侧踝关节骨折的高发年龄段为21 ～30岁,距骨复杂骨折构成比最高,81-B型距骨骨折合并44-A2组踝关节骨折最多见,前、后5年患者的性别、年龄构成等方面未发生明显变化.

Objective To investigate the epidemiological features and analyze the trends of talar combined ipsilateral and ankle fractures in the adult patients in the last decade at our hospital.Methods The data of human fractures treated between 2003 January to 2012 December at our hospital were collected through the PACS system and case reports checking system.Adult talar fractures were included in this study.The data of talar fractures were classified as group A,those of combined talar fractures as group B and those of talar combined with ipsilateral ankle fractures as group C.The 3 groups were compared and analyzed in terms of gender,age,fracture type （AO/OTA）,epidemiological trends between the first 5 years and the last 5 years.Results A total of 158 adults with talar and concomitant ipsilateral ankle fractures were treated,accounting for 52.15% of the combined talar fractures and 27.77% of all the talar fractures.The age distribution showed that the peak age of talar and concomitant ipsilateral ankle fractures was from 21 to 30 years old.There were no significant difference in gender or age distribution between groups A and C （χ^2 =2.564,P =0.109; χ^2 =5.970,P =0.309）.The percentage of complex talus fracture in group C was significantly higher than that in group A （χ^2 =7.105,P =0.008）.There were no significant differences in gender or age distribution in group C between the first and the last 5 years （χ^2 =0.722,P =0.395;χ^2 =5.493,P =0.359）.There was no significant difference in the ratio of group C to group B between the first and the last 5 years （χ^2 =0.232,P =0.630）.Fractures of type 81-B combined with type 44-A2 were the most frequent injury,accounting for 32.91% of the talus concomitant ipsilateral ankle fractures,displaying no significant difference between the first and the last 5 years in group C （χ^2 =2.912,P =0.088）.The percentages of all the talar fracture types showed no significant difference between the first and the last 5 years （P 〉 0.05）.Conclusions The peak age of the combined fractures of the ipsilateral talus and ankle was from 21 to 30 years old.The percentage of complex talar fractures was the highest.Fractures of type 81-B combined with type 44-A2 was the most common injury.There were no significant changes in gender or age distribution between the first and the last 5 years of the last decade.