2010年至2011年中国东部和西部地区第一掌骨基底骨折的流行病学对比分析

Epidemiological comparison of fractures at the base of the first metacarpal bone between East and West China from 2010 to 2011

目的对比分析我国东部地区和西部地区第1掌骨基底骨折的流行病学特征。方法回顾性分析2010年1月至2011年12月我国东部地区和西部地区63所医院诊治的第1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。将东部地区35所医院的患者资料定义为A组，西部地区28家医院的患者资料定义为B组，对比分析两组患者的性别、年龄、各年龄段骨折例数及骨折分型等。结果共收集890例第1掌骨基底骨折患者，男女比为4．56：1，高发年龄段为青年组；Ⅲ型骨折最多，占44．49％（396／890）。A组621例，男女比为4．59：1；B组269例，男女比为4．49：1，两组患者性别构成比较差异无统计学意义（P〉0．05）。A组年龄中位数39岁大于B组35岁，差异有统计学意义（Z==3．687，P〈0．001）。两组高发年龄段均为青年组，右侧多于左侧。A组青年组构成比低于B组，中年组构成比高于B组（P〈0．05），儿童组和老年组构成比差异均无统计学意义（P〉0．05）。两组骨折高发类型均为Ⅲ型，A组Ⅰ型骨折构成比高于B组，Ⅱ型骨折构成比低于B组，差异有统计学意义（P〈0．05），Ⅲ、Ⅳ型骨折构成比差异无统计学意义（P〉0．05）。结论第1掌骨基底骨折多见于青年男性，右侧多于左侧，高发骨折类型为Ⅲ型。东部地区Ⅰ型的构成比高于西部地区，Ⅱ型的构成比低于西部地区。

Objective To compare and analyze the epidemiological features of fractures at the base of the first metacarpal bone between East and West China. Methods We retrospectively analyzed the clinical data of the patients with fracture at the base of the first metacarpal bone who had been treated from January 2010 to December 2011 in 63 hospitals in the east and west areas of China. The data from 35 hospitals in East China were classified as group A while the data from 28 hospitals in West China as group B. The analytic items included gender, age, age distribution and fracture classification. Results A total of 890 cases were collected. The total male/female ratio was 4.56： 1. The youth accounted for the highest proportion and the high-risk type of fracture was type m （44. 49%, 396/890）. The male/female ratio was 4.59：1 in group A of 621 patients and 4.49：1 in group B of 269 patients, showing no statistic between-group difference （P 〉 0. 05） . The median age in group A was 39 years, significantly older than that in group B （35 years） （ Z = - 3. 687, P 〈 0. 001 ）. In both groups, the youth accounted for the highest proportion and there were more fight-side fractures than left-side ones. Group A had a significantly lower proportion of the youth and a significantly higher proportion of the middle-aged than group B （ P 〈 0.05）, but there was no statistic dif-ference in proportions of the children and the aged （ P 〉0. 05） . Type Ⅲ was the high-risk type in both groups; group A had significantly more fractures of type I and significantly fewer fractures of type Ⅱ than group B （ P 〈 0. 05）, but there was no statistic difference in proportions of type Ⅲ and type Ⅳ between the 2 groups （ P 〉 0. 05）. Conclusions Fractures at the base of the first metacarpal bone mostly occurred in the young males. There were more fractures at the right side than at the left side. The most frequent type was type Ⅲ. The proportion of type I fractures in East China was higher than in West China while the proportion of type Ⅱ fractures in East China lower than in West China.