2003年至2012年河北医科大学第三医院成人第一掌骨基底骨折的流行病学研究

Epidemiological analysis of adult fractures at the base of the first metacarpal bone 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第一掌骨基底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月河北医科大学第三医院收治的成人第一掌骨基底骨折患者资料，记录患者的性别、年龄、损伤侧别及骨折分型等数据。将2003年1月至2007年12月收治的患者定为A组，2008年1月至2012年12月收治的患者定为B组，比较两组患者的性别构成、年龄段分布和骨折类型，总结出10年期间成人第一掌骨基底骨折的流行病学特征及变化趋势。结果10年间共采集成人第一掌骨基底骨折378例，占同期手部骨折的1．92％，占同期全身骨折的0．35％。男311例（82．28％），女67例（17．72％）。青年组254例，构成比最高（67．20％）。右侧286例（75．66％），左侧92例（24．34％）。关节外骨折198例，构成比最高（52．38％）。A组200例，男女比为6．14：1，中位数年龄为34岁，青年组构成比最高（73．50％），A1型骨折构成比最高（53．50％）；B组178例，男女比为3．56：1，中位数年龄为40岁，青年组构成比最高（60．11％），A1型骨折构成比最高（51．12％）。与A组比较，B组患者女性构成比高、年龄大、老年组构成比高、青年组构成比低、c1型骨折构成比低，差异均有统计学意义（P〈0．05）。结论成人第一掌骨基底骨折占手部骨折的1．92％，占全身骨折的0．35％。男性明显多于女性，好发于16～44岁，约3／4位于右侧。前、后5年比较，女性及老年患者呈增多趋势，青年患者及cl型骨折呈减少趋势。

Objective To investigate the epidemiological features and trends of aduh fractures at the base of the first metacarpal bone in The Third Affiliated Hospital to Hebei Medical University from 2003 through 2012. Methods The data of human fractures treated between January 2003 to December 2012 at our hospital were collected through the PACS system and case reports checking system. Adult fractures at the base of the first metacarpal bone were included in the present study and assigned into 2 groups, group A containing the data between 2003 and 2007 and group B the data between 2008 and 2012. Comparison and analysis was done with analytic items of gender, age and fracture type. Results A total of 378 adult fractures at the base of the first metacarpal bone were included, accounting for 1.92% of hand fractures and 0. 35% of the total adult fractures at the same period. The fractures involved 311 males （82.28%） and 67 females （17.72%） . The youth group had 254 fractures with the highest constituent ratio （67.20%） . The right side was involved in 286 cases （75.66%） and the left side in 92 （24.34%）. There were 198 cases of extra-articular fracture with the highest constituent ratio （52. 38% ） . Group A had 200 fractures, a male to female ratio of 6. 14： 1, a median age of 34 years, the highest constituent ratio in youth （73.50%） and intype A1 fractures （53.50%）; group B had 178 fractures, a male to female ratio of 3.56： 1, a median age of 40 years, the highest constituent ratio in youth （60. 11% ） and in type A1 fractures （51. 12% ）. Compared with group A, group B had a higher constituent ratio of females, older ages, a higher constituent ratio of el- derly patients, a lower constituent ratio of youth, and a lower constituent ratio of type C1 fractures. All these differences between the 2 groups were statistically significant （ P 〈 0.05 ）. Conclusions During the 10 year, the adult fractures at the base of the first metacarpal bone accounted for 1.92% of hand fractures and 0. 35% of the total adult fractures at the same period. The fractures occurred mostly in men and in the age range of 16 to 44 years. About 3/4 of them occurred on the right side. Compared with the first 5 years, the latter 5 years witnessed increasing trends of female and elderly patients and decreasing trends of young patients and type Ct fractures.