Singh指数与老年股骨粗隆间骨折术后再骨折的相关性

The correlation between Singh index and re-fracture after operation for intertrochanteric fractures in the elderly

目的:回顾性研究股骨粗隆间骨折术后近期、远期再骨折患者与单次股骨粗隆间骨折患者的Singh指数评分,评估Singh指数评分对股骨粗隆间骨折患者的应用价值。方法:回顾性分析收治的266例股骨粗隆间骨折患者,研究Singh指数与老年股骨粗隆间骨折再骨折相关性。结果:首次髋部骨折患者术后对侧发生骨折平均时间为20个月,其中术后近期(≤12月)发生5例,平均时间8个月,术后远期(>12月)发生7例,平均时间35个月。术后近期骨折患者占股骨粗隆间患者比重为1.88%(5/266)。近期二次骨折组Singh指数平均4.6分,平均年龄84岁;远期二次骨折组Singh指数平均3.2分,平均年龄82岁。两组患者Singh指数评分、年龄比较,差异均有统计学意义(P<0.05)。远单侧髋部骨折组与近期二次骨折组比较,在年龄、Singh指数评分差异有统计学意义(P<0.05),单侧髋部骨折组与近期二次骨折组比较,年龄、Singh指数评分差异无统计学意义(P>0.05)。结论:股骨粗隆间骨折患者年龄≥76岁、Singh指数评分≥3分(Singh指数等级≤4级)需要针对性预防二次股骨粗隆间骨折。

Objective The Singh index scores of patients with short-term and long-term femoral intertrochanteric fractures and single intertrochanteric fractures were studied retrospectively,and the application value of Singh index scores for patients with intertrochanteric fractures was evaluated.Method 266 patients with femoral intertrochanteric fracture were analyzed retrospectively to study the relationship between Singh index and re-fracture of femoral intertrochanteric fracture in the elderly.Results The average time of contralateral fracture in patients with first hip fracture was 20 months,of which 5 cases occurred in the short term(≤12 months),with an average time of 8 months,and 7 cases occurred in the long term(>12 months),with an average time of 35 months.The proportion of patients with short-term postoperative fracture in intertrochanteric femur was 1.88%(5/266).The average Singh index of the short-term secondary fracture group was 4.6 points and the average age was 84 years old,while the average Singh index of the long-term secondary fracture group was 3.2points and the average age was 82 years old.There were significant differences in Singh index score and age between the two groups(P<0.05).There was significant difference in age and Singh index score between the distal unilateral hip fracture group and the recent secondary fracture group(P<0.05),but there was no significant difference in age and Singh index score between the unilateral hip fracture group and the recent secondary fracture group(P>0.05).Conclusion It is necessary to prevent secondary hip fracture in patients with intertrochanteric fracture of femur whose age is≥76 years old and Singh index score≥3 points(Singh index grade≤4).