2010年至2019年河北医科大学第三医院老年肱骨外科颈骨折临床特征的变化趋势分析

Epidemiological study of geriatric humeral surgical neck fractures from 2010 to 2019 in The Third Hospital of Hebei Medical University

目的分析10年间河北医科大学第三医院收治的老年肱骨外科颈骨折的临床特征及变化趋势。方法收集河北医科大学第三医院2010年1月1日至2019年12月31日收治的年龄≥60岁的肱骨外科颈骨折住院患者的一般资料、疾病相关信息及影像学资料并进行回顾性分析,将病例按照入院年份划分为前5年组(A组,2010年1月1日至2014年12月31日)和后5年组(B组,2015年1月1日至2019年12月31日),比较两组患者的一般资料,总结出10年间老年肱骨外科颈骨折的流行病学特征及变化趋势。结果共纳入老年肱骨外科颈骨折患者312例,占同期上肢骨折的1.2%(312/25764),占同期全身骨折的0.4%(312/88886)。男64例,女248例,男女比为0.26∶1;年龄为60~93岁。骨折高发年龄段为60~69岁,其中男性为60~69岁,女性为60~69岁;跌倒伤和室内活动损伤占比最高(71.2%,222/312);高发骨折类型为11-A2、11-A3型;体重指数评价为超重及肥胖患者总数占比最高(58.7%,183/312)。A、B组患者的男女比(0.37∶1、0.22∶1)和高发年龄段(60~69岁)所占构成比[42.7%(38/89)、55.2%(123/223)]差异均无统计学意义(P>0.05)。两组患者的致伤原因、骨折分型和体重指数分布差异均有统计学意义(P<0.05)。结论老年肱骨外科颈骨折占同期上肢骨折的1.2%,占同期全身骨折的0.4%。临床特征的变化趋势为女性多于男性,跌倒和室内活动损伤为更常见致伤原因,复杂骨折、超重及肥胖患者比例增高。

Objective To analyze the epidemiological features of geriatric humeral surgical neck fractures from 2010 through 2019 in The Third Hospital of Hebei Medical University.Methods A retrospective study was conducted of the data of the inpatients aged≥60 years who had been treated for humeral surgical neck fractures in The Third Hospital of Hebei Medical University from 2010 through 2019.The patients were divided into 2 groups by the year of admission:the former five-year group(group A from January 1,2010 to December 31,2014)and latter five-year group(group B from January 1,2015 to December 31,2019).The data of the patients were compared between the 2 groups to find the epidemiological characteristics and trends of the humeral surgical neck fractures in the 10-year period.Results A total of 312 geriatric humeral surgical neck fractures were included,accounting for 1.2%(312/25,764)of the upper limb fractures and 0.4%(312/88,886)of all the fractures in the same period.There were 64 males and 248 females,giving a male/female ratio of 0.26∶1.Their ages ranged from 60 to 93 years.The peak age of the fractures was from 60 to 69 years for both males and females.Falls and indoor activity injuries accounted for the largest proportion(71.2%,222/312).The common fracture types were 11-A2 and 11-A3.The proportion of overweight and obese patients by the body mass index(BMI)was the largest(58.7%,183/312).There were no statistically significant differences between groups A and B in male/female ratio(0.37:1 versus 0.22:1)or in proportion of peak age patients[42.7%(38/89)versus 55.2%(123/223)](P>0.05).There were statistically significant differences between the 2 groups in injury causes,fracture types and BMI distribution(P<0.05).Conclusions The geriatric humeral surgical neck fractures accounted for 1.2%of the upper limb fractures and 0.4%of all the fractures in the same period.There were more female patients than male ones.Falls and indoor activity injuries were the most common causes.The proportions of complex fractures and overweight and obese patients increased.