2003年至2012年河北医科大学第三医院成人pilon骨折的流行病学分析

Epidemiological analysis of adult pilon fractures in the Third Affiliated Hospital to Hebei Medical University from 2003 through 2012

目的 探讨10年期间河北医科大学第三医院成人pilon骨折的流行病学特征及变化趋势.方法 回顾性分析2003年1月至2012年12月期间河北医科大学第三医院收治的成人pilon骨折患者资料,记录患者的性别、年龄、骨折Ruedi-Allgtiwer分型等数据.将2003年1月至2007年12月的患者资料定为A组,2008年1月至2012年12月的患者资料定为B组,比较两组患者的一般资料,总结出10年期间成人pilon骨折的流行病学特征及变化趋势.结果 共收治784例成人pilon骨折患者,占同期成人胫腓骨骨折的4.25％ （784/18 432）,占同期成人全身骨折的0.73％ （784/107 648）.男621例,女163例,男女比为3.81∶1;骨折高发年龄段为41～50岁（27.42％）,高发骨折类型为Ruedi-Allg（o）wer Ⅰ型（36.35％）.A组330例,男女比为4.32∶1,平均年龄为（39.8±14.2）岁.B组454例,男女比为3.50∶1,平均年龄为（40.6±13.6）岁.两组患者男女比和平均年龄比较差异均无统计学意义（P＞0.05）.B组21～ 30岁和41 ～50岁年龄段患者构成比、Ⅰ型骨折患者构成比高于A组,而31 ～40岁年龄段患者构成比及Ⅱ型骨折患者构成比低于A组,差异均有统计学意义（P＜0.05）. 结论 成人pilon骨折占同期成人胫腓骨骨折的4.25％,占同期成人全身骨折的0.73％;骨折多见于男性,骨折高发年龄段为41 ～50岁,高发骨折类型为Ruedi-Allgower Ⅰ型.与前5年比较,后5年21 ～30岁和41 ～50岁年龄段患者构成比、Ⅰ型骨折患者构成比增高,而31 ～40岁年龄段患者构成比、Ⅱ型骨折患者构成比降低.

Objective To investigate the epidemiological features and trends of adult pilon fractures in the Third Affiliated Hospital to Hebei Medical University from 2003 through 2012.Methods The data of adult pilon fractures treated between January 2003 and December 2012 at our hospital were analyzed retrospectively.The patients＇ gender,age,age distribution and type of Ruedi-Allgower classification were documented.The data between January 2003 and December 2007 were classified as group A while the data between January 2008 and December 2012 were designed to group B.Comparisons were conducted between the 2 groups to find out the general epidemiological characteristics and trends of adult pilon fractures during the 10 years.Results A total of 784 aduh pilon fractures were collected,accounting for 4.25% （784/18,432） of the tibial and fibular fractures and 0.73% （784/107,648） of systemic fractures in adults at the same period.The fractures involved 621 males and 163 females,giving a male/female ratio of 3.81∶ 1.The peak age of pilon fractures ranged from 41 to 50 years （27.42%）.Their high-risk type was Ruedi-Allgower type Ⅰ （36.35%）.There were 330 cases in group A,with a male/female ratio of4.32∶1 and a mean age of 39.8 ± 14.2 years.There were 454 cases in group B,with a male/female ratio of3.50∶1 and a mean age of 40.6 ± 13.6 years.There was no statistically significant difference in male/female ratio or mean age between the 2 groups （P 〉 0.05）.The proportions of patients with 21 to 30 years old and 41 to 50 years old and type Ⅰ in group B were significantly higher than in group A （P 〈 0.05）,and the proportions of patients with 31 to 40 years old and type]Ⅱ in group B were significantly lower than in group A （P 〈 0.05）.Conclusions In the Third Affiliated Hospital to Hebei Medical University from 2003 through 2012,adult pilon fractures accounted for 4.25% of adult tibial and fibular fractures and 0.73% of adult systemic fractures.Male patients were more common than female ones.The peak age ranged between 41 and 50 years.Ruedi-Allgower type Ⅰ was the most common.Compared with the first 5 years,the second 5 years witnessed increased proportions of patients with 21 to 30 years old and 41 to 50 years old and type Ⅰ but decreased proportions of patients with 31 to 40 years old and type Ⅱ.