对低能量股骨颈与转子间骨折的流行病学特征的观察

Epidemiologic characteristics of low-energy femoral neck and intertrochanteric fractures

目的探讨低能量股骨颈骨折与转子间骨折患者的流行病学特征、骨密度测量情况。方法回顾分析2015年1至12月北京积水潭医院放射科急诊低能量髋部骨折共计670例患者的影像资料、调查问卷、X线骨密度仪(DXA)髋部骨密度结果。年龄为(73.8±13.3)岁。应用t检验比较组间的年龄、身高、体重等,应用χ2检验分析性别、骨密度等的组间差异。结果本组低能量股骨颈与转子间骨折患者主要为平地跌倒,多见于女性(66%),多发生于秋季。股骨颈骨折人数与转子间骨折人数的比值为1.51,后者年龄比前者大4.6岁(t=-4.4,P<0.01)。仅30%的患者接受了DXA的髋部骨密度检查,但是T-值≤-2.5的情况为79%;转子间骨折组的骨密度减低更严重(χ^2=5.2,P=0.02)。结论低能量股骨颈与转子间骨折多见于老年女性;转子间骨折更多见于高龄人群。虽然骨折人群骨密度减低情况严重,但是接受骨密度监测的比例过少。

Objective To investigate the epidemiologic characteristics and bone mineral density(BMD)of low-energy femoral neck fractures(FN)and intertrochanteric fractures(IT).Methods From January to December 2015,670 patients with low-energy hip fractures in Department of Radiology,Beijing Jishuitan Hospital,were admitted into this research.The age of patients were(73.8±13.3)years.The epidemiologic data and hip BMD were collected and analyzed.Results All the cases of low-energy FN and IT fractures were identified.Most of them occurred due to falling.Among them 66%were women.The cases of FN group were more than IT group.However,the average age of IT group was 4.6 years older than FN group(t=-4.4,P<0.01).Only 30%of patients had been followed by DXA,but 79%of them had lower BMD(T-value≤-2.5).The rate of lower BMD was higher in IT group(χ^2=5.2,P=0.02).Conclusions Low-energy femoral neck and intertrochanteric fractures occur more often among elder women.The intertrochanteric fractures are more common in the old people.Although most of the patients have lower BMD,much less of them are followed by BMD assessment.