呼和浩特市1638例股骨转子间骨折流行病学分布特征分析

Epidemiological characteristics of 1 638 patients with femoral intertrochanteric fractures in Hohhot

背景:股骨转子间骨折的发生与患者的性别、年龄、地域环境因素及种族等因素密切相关,目前国内关于内蒙古地区股骨转子间骨折的流行病学研究少见报道。目的:调查呼和浩特市股骨转子间骨折流行病学分布特征。方法:回顾性研究2008年5月至2015年4月呼和浩特市4所医院1 638例股骨转子间骨折患者的临床资料,采集患者的年龄、性别、致伤原因、受伤时间和骨折分型,并进行流行病学特征描述。结果与结论:(1)各年龄段中以70-79岁年龄段患者所占比例最高(27.35%),老年人总体比例高达61.17%,而老年人中尤以75-89岁老年人最多(33.82%),儿童人数最少(6.53%);50岁之前的男性患者人数多于女性,且在10-19岁年龄段有个发病小高峰,但50岁之后的女性患者人数明显多于男性(P<0.05);(2)摔倒伤(50.61%)明显高于其他致伤原因(P<0.05),是股骨转子间患者的主要受伤机制,但交通伤和坠落伤也是男性患者的主要受伤机制;(3)从季节流行趋势特点上来看,冬季发病率最高(36.75%),春季发病人数最低(15.75%);11月发病人数最高,7月发病人数最低;(4)Evans分型中以Ⅲ型骨折为主(35.23%),不稳定性骨折组比例要明显高于稳定性骨折组(63.74%vs.36.26%)(P<0.05);AO分型中以31-A2型比例最高(57.02%);(5)结果说明,呼和浩特市市股骨转子间骨折患者在年龄、性别、致伤原因、受伤时间、骨折分型等方面具有一定的流行病学分布特征。

BACKGROUND： Femoral intertrochanteric fractures are closely related to sex, age, geographical environment and race. But there is a lack of epidemiology studies on femoral intertrochanteric fractures in the Inner Mongolia Autonomous Region. OBJECTIVE： To investigate the epidemiological features of femoral intertrochanteric fractures in Hohhot. METHODS： The clinical data of 1638 patients with femoral intertrochanteric fractures admitted in four hospitals of Hohhot from May 2008 to April 2015, including their age, gender, the etiology, time of injury, fracture types, were collected and reviewed retrospectively, and the distribution of the epidemiological characteristics were described. RESULTS AND CONCLUSION： Patients aged 70-79 years accounted for 27.35%, which was the highest in all groups. The overall proportion of older patients was up to 61.17%, among whom, the number of patients with the age of 75-89 years （33.82%） was the highest, and the number of children was the lowest （6.53%）. The number of male patients was higher than that of female patients before the age of 50 years, and there was a small peak incidence in age of 10-19 years, but the number of female patients was more than that of male patients after 50 years （P 〈 0.05）. Falling down became the leading cause of femoral intertrochanteric injury, accounting for 50.16% （P 〈 0.05）; in addition, traffic and high falling injuries were also the major injury causes in male patients. The highest incidence of femoral intertrochanteric fractures occurred in winter （36.75%）, while the lowest incidence was found in spring （15.75%）. The incidence of femoral intertrochanteric fractures showed the epidemic peak in November, while it was lowest in July. According to the Evans classification, type Ⅲ was the most common （35.23%）, and the proportion of unstable fracture was significantly higher than that of stable fracture （63.74% vs. 36.26%, P 〈 0.05）. 31-A2 fractures accounted for 57.02% in AO classification. To conclude, the distribution of patients with femoral intertrochanteric fractures in Hohhot exhibits certain epidemiological characteristics in the aspects of age, sex, etiology, time of injury, and fracture types.