2010年至2011年河北省多中心成人胫骨干骨折流行病学研究

Multi-center epidemiological survey of adult tibial shaft fractures from 2010 through 2011 in Hebei Province

目的调查河北省成人胫骨干骨折的流行病学特征并分析其地区差异。方法收集2010年1月至2011年12月期间河北医科大学第三医院（石家庄地区，A组）、沧州市中西医结合医院（沧州地区，B组）、唐山市第二医院（唐山地区，C组）三所医院诊治的所有成人骨折患者资料，筛选出成人胫骨干骨折患者资料进行回顾性分析，统计患者性别、年龄、骨折AO／OTA分型等数据，总结成人胫骨干骨折流行病学特征并对比分析3组数据。结果成人胫骨干骨折3559例，占同期胫腓骨骨折的28．20％，占同期全身骨折的4．85％。男女比为4．21：1，骨折高发年龄段为36—45岁（25．96％），男、女骨折高发年龄段均为36～45岁，构成比分别为26．36％、24．30％；高发类型为42-A型（49．73％），男、女骨折高发类型均为42．A型，构成比分别为47．88％、57．54％；复杂骨折男女比均高于简单骨折，42-B型和42-C型均高于42-A型，差异均有统计学意义（P〈0．05）。A、B、C3组成人胫骨干骨折占同期胫腓骨骨折比例分别为21．17％、30．62％、31．67％，三组间比较差异有统计学意义（P〈0．05），A组分别与B、C组比较差异均有统计学意义（P〈0．05）；占同期全身骨折比例分别为3．32％、3．78％、6．91％，三组间比较均有统计学意义（P〈0．05）。B组36～45岁骨折高发年龄段构成比（29，46％）显著高于A、C组（23．77％、25．58％），C组≥66岁男性构成比（2．94％）显著高于B组（2．19％），A组≥66岁患者构成比（6．12％）显著高于C组（3．52％），以上项目比较差异均有统计学意义（P〈0．05）。A组复杂骨折构成比（56．30％）显著高于B、C组（50．00％、47．83％），差异均有统计学意义（P〈0．05）。结论河北省成人胫骨干骨折男性多于女性，随着年龄增长女性所占比例逐渐增高，高发年龄段为36～45岁，高发骨折类型为42-A型，复杂骨折男、女比高于简单骨折。沧州地区骨折高发年龄段（36～45岁）构成比最高，唐山地区老年男女比最高，石家庄地区复杂骨折构成比最高。

Objective To investigate the epidemiological features of adult tibial shaft fractures in Hebei Province and compare their regional differences. Methods All the clinical data of adult fractures from January 2010 through December 2011 were collected from The Third Affiliated Hospital to Hebei Medical University （Group A, Shijiazhuang）, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine （Group B, Cangzhou）, and The Second Hospital of Tangshan （Group C, Tangshan）. Adult tibial shaft fractures were selected and analyzed retrospectively. Analytic items included gender, age, AO/OTA fracture type. The epidemiological characteristics of adult tibial shaft fractures in Hebei Province were summarized. Comparisons and analyses were made among the 3 groups. Results A total of 3,559 adult tibial shaft fractures were selected, accounting for 28.20% of the tibial and fibular fractures and 4.85% of all the adult fractures at the same period. The male/female ratio was 4.21： 1. The age distribution showed that the peak age of tibial shaft fracture was from 36 to 45 years （25.96 % ）, and no significant difference was observed between males （26.36%） and females （24. 30% ） . Type 42-A ones were the most common, accounting for 49.73% of all the tibial shaft fractures. It is also the most common in both men （47.88%） and women （57.54%）. The male/female ratio in complex fractures was higher than that in simple fractures. The male/female ratios in type 42-B and type 42-C were significantly higher than that in type 42-A （ P 〈 0. 05）. The proportions of adult tibial shaft fractures in tibial and fibular fractures accounted for 21.17% in group A, 30. 62% in group B, and 31.67% in group C, respectively. The differences among the 3 groups were statistically significant （ P 〈 0. 05 ）. The differences between group A and group C as well as between group A and group B were statistically significant （ P 〈 0. 05 ）. The proportions of adult tibial shaft fractures in all the adult fractures accounted for 3.32% in group A, 3.78% in group B, and 6. 91% in group C, respectively. There were statistically significant differences among the 3 groups （ P 〈 0.05）. The constituent ratio of the peak age （from 36 to 45 years old） in group B was significantly higher than those in group A （23.77%） and group C （25.58%） （ P 〈 0.05）. The constituent ratio of the old males （ ≥ 66 years） in group C（2. 94% ） was significantly higher than that in group B （2. 19% ） （ P 〈 0.05）. The constituent ratio of the old males （ ≥ 66 years） in group A （6. 12% ） was significantly higher than that in group C （3.52%） （ P 〈 0. 05）. The constituent ratio of complex fractures in group A （56.30%） was significantly higher than those in group B （50.00%） and group C （47.83%） （ P 〈 0. 05）. Conclusions In Heibei Province from 2010 through 2011, more men suffered from tibial shaft fracture than women. The proportion of female patients increased with the increase in age. The peak age of tibial shaft fracture was from 36 to 45 years old. Type 42-A ones were the most common. The male/female ratio in complex fractures was higher than that in simple ones. The constitution of the peak age group （from 36 to 45 years old） was the highest in Cangzhou. The constitution of the old male patients was the highest in Tangshan. The constitution of the complex fractures was the highest in Shijiazhuang.