影响老年低能量股骨粗隆间骨折稳定性的相关因素分析

Analysis of Factors Influencing the Stability of Low Energy Femoral Intertrochanteric Fracture in the Elderly

目的:探讨低能量损伤下影响老年人股骨粗隆间骨折稳定性的相关因素,以充实股骨粗隆间骨折治疗方面的经验。方法:对2016年1月至2018年9月在河南省洛阳正骨医院(河南省骨科医院)髋部诊疗中心就诊股骨粗隆间骨折患者进行回顾性分析,筛选出符合纳入标准的病例并参照Evans-Jensen分型将骨折分为稳定性骨折(Ⅰ型与ⅡA型)和不稳定性骨折(ⅡB型、Ⅲ型与逆粗隆间骨折),对两组患者的年龄、性别、股骨近端骨密度(大粗隆部位、颈部及Wards三角区域)、体质量指数(BMI)及股骨颈干角进行分析。结果:本研究最终纳入病例91例,其中稳定组42例,不稳定组49例。两组患者的性别、年龄与BMI相比较,差异无统计学意义(P>0.05);股骨颈区域的骨密度值差异无统计学意义(P>0.05),而股骨大粗隆区域及Wards三角区域的骨密度比较差异有统计学意义(P<0.05);股骨颈干角大小相比较,无论男女,差异均无统计学意义(P>0.05)。结论:股骨大粗隆区域及Wards三角区域的骨密度与股骨粗隆间骨折的稳定性可能相关,而患者年龄、性别、BMI、股骨颈区域骨密度、股骨颈干角与股骨粗隆间的稳定性可能无相关性。

Objective:To investigate the factors affecting the stability of intertrochanteric fractures in the elderly under lowenergy injury,so that to enrich the data on treatment of intertrochanteric fractures.Methods:A retrospective analysis of patients with intertrochanteric fractures at the hip clinic in Luoyang Zhenggu Hospital of Henan Province from January 2016 to September 2018 was conducted.Screening for cases meeting the inclusion criteria and reference,and according to Evans-Jensen classification divided fractures into stable fractures(typeⅠandⅡA)and unstable fractures(typeⅡB,typeⅢand intertrochanteric fractures).Age,gender,the bone mineral density of proximal femur(large trochanter,neck and Wards triangle),body mass index(BMI)and collodiaphyseal angle of the two groups of patients were analyzed.Results:A total of 91 patients were included in the study,including 42 in the stable group and 49 in the unstable group.There were no significant differences in gender,age and BMI between the two groups.There was no significant difference in bone mineral density in the area of femoral neck between the two groups(P>0.05).Conclusion:Bone mineral density in the femoral trochanteric region and the Wards triangle region is closely related to the stability of the intertrochanteric fracture,while there was no siginificant correlation in stability of femoral trochanteric with the patient’s age,gender,BMI,femoral neck bone mineral density,collodiaphyseal angle femoral neck stem angle.