Intertrochanteric femoral fractures: an epidemiological analysis of 618 cases

doi:10.3969/j.issn.2095-4344.1110

Abstract

Abstract:

BACKGROUND: Epidemiological characteristics of the intertrochanteric femoral fractures in Urumqi of Xinjiang Uygur Autonomous Region are rarely reported. Moreover, there is a lack of the epidemiological survey on the incidence, treatment and short-term prognosis.

OBJECTIVE: To study the epidemiological characteristics of the intertrochanteric femoral fractures of the inpatients, so as to provide a scientific basis for strategic study on the prevention and treatment of the intertrochanteric femoral fractures.

METHODS: Clinical data of 618 patients with intertrochanteric femoral fractures admitted in the First Affiliated Hospital of Xinjiang Medical University from January 2007 to December 2017 were analyzed retrospectively. The patient characteristics, injury time and causes, treatment methods, intraoperative indexes, hospitalization time, hospitalization costs and mortality at 6 months after treatment were collected for analyzing the epidemiological characteristics. SPSS 22.0 software was used for data analysis.

RESULTS AND CONCLUSION: (1) There were significant differences in distribution of the intertrochanteric femoral fractures in terms of age and sex (P < 0.05). The amount of patients aged ≥ 61 years was most, accounting for 81.39%. The left side was more than right side (1.04:1). The proportion of male patients was more than female patients (1.01:1). (2) The number of patients increased with time increasing (P < 0.05). Season distribution of injury showed significant difference (P < 0.01), most injured in winner (44.5%). (3) The number of patients from Urumqi accounted for most, 300 cases (48.54%). (4) There was significant difference in the distribution of injury cause (P < 0.05), and slip was the leading cause (78.64%). Distribution of injury cause was significantly different at different ages and sexes (P < 0.05). (5) There was no significant difference in time distribution from injure to surgery in patients with different ages (P > 0.05). (6) Surgery was the predominant management approaches, accounting for 89.32%. At 6 months after surgery, the mortality rate of surgical treatment was significantly lower than that of conservative treatment (P < 0.05). (7) In summary, the distribution of the intertrochanteric femoral fractures of the inpatients has unique characteristics in aspects of age, sex, area distribution, injury causes, injury time, time from injury to surgery, treatment methods, and mortality at 6 months after treatment, which is worthy of further strategic study on prevention and treatment of the intertrochanteric femoral fractures.

Key words: Hip Fractures, Epidemiology, Retrospective Studies

CLC Number:

R496

Guo Jinchao1, Cao Yuan2, Huang Junling1, Ma Jiajia1, Ma Chuang1. Intertrochanteric femoral fractures: an epidemiological analysis of 618 cases[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(12): 1840-1845.

Figures/Tables 8

References

[1] Sterling RS. Gender and Race/Ethnicity Differences in Hip Fracture Incidence, Morbidity, Mortality, and Function.Clin Orthop Relat Res.2011;469(7):1913-1918.

[2] Sambandam SN,Chandrasekharan J,Mounasamy V,et al.Intertrochanteric fractures: a review of fixation methods.Eur J Orthop Surg Traumatol. 2016;26(4):339-353.

[3] Hu F, Jiang C, Shen J, et al.Preoperative predictors for mortality following hip fracture surgery: A systematic review and meta-analysis. Injury.2012;43(6):676-685.

[4] 梁玉柱,郭洪刚.股骨转子间骨折179例流行病学调查:天津医科大学总医院2013至2015年就诊资料分析[J].中国组织工程研究,2018,22(8): 1167-1172.

[5] 姬晨妮,陈伟,朱燕宾,等.京津唐地区1583例老年股骨转子间骨折流行病学特征分析[J].中华老年骨科与康复电子杂志, 2015(1):45-49.

[6] 张飞,陈伟,张晓琳,等.成人股骨转子间骨折的临床特点及其变化:单中心3201例分析[J].中华外科杂志, 2014,52(9):697-701.

[7] 中国老年医学学会骨与关节分会创伤骨科学术工作委员会.老年髋部骨折诊疗专家共识(2017)[J].中华创伤骨科杂志, 2017,19(11): 921-927.

[8] 王长海,马志新,毕力夫.呼和浩特地区髋部骨质疏松性骨折的回顾性研究(附1071例病例分析)[J].中国骨质疏松杂志, 2010,16(3):207-209.

[9] 李洪秋,阿良,赵忠海,等.沈阳地区老年髋部骨质疏松性骨折流行病学调查分析[J].中国骨质疏松杂志, 2013,19(3):293-296.

[10] 尹英民,林伟龙,沈海敏,等.髋部骨折1266例流行病学调查分析[J].老年医学与保健,2013, 19(3):161-164.

[11] Yu J,Tang J,Li Z,et al.History of cardiovascular events and cardiovascular risk factors among patients initiating strontium ranelate for treatment of osteoporosis.Int J Womens Health. 2015;7:913-918.

[12] Dennison EM,Syddall HE,Sayer AA,et al.Type 2 diabetes mellitus is associated with increased axial bone density in men and women from the Hertfordshire Cohort Study: evidence for an indirect effect of insulin resistance.Diabetologia.2004; 47(11): 1963-1968.

[13] Schwartz AV,Sellmeyer DE,Strotmeyer ES,et al.Diabetes and Bone Loss at the Hip in Older Black and White Adults.J Bone Miner Res. 2005;20(4):596-603.

[14] Binks S,Dobson R.Risk Factors, Epidemiology and Treatment Strategies for Metabolic Bone Disease in Patients with Neurological Disease. Curr Osteoporos Rep. 2016;14(5):199-210.

[15] Mayor S. Parkinson’s disease diagnosis is preceded by increased risk of falls, study finds.Bmj, 2016;352:i695.

[16] Fu MC, Boddapati V, Gausden EB, et al. Surgery for a fracture of the hip within 24 hours of admission is independently associated with reduced short-term post-operative complications.Bone Joint J. 2017; 99-B(9):1216-1222.

[17] Sobolev B, Guy P, Sheehan KJ, et al.Mortality effects of timing alternatives for hip fracture surgery. CMAJ. 2018;190(31):E923-E932.

[18] 袁志,毕龙.老年股骨转子间骨折的治疗趋势[J].中华骨科杂志, 2017, 37 (17):1057-1060.

[19] Mortazavi SM, R Greenky M, Bican O, et al. Total hip arthroplasty after prior surgical treatment of hip fracture is it always challenging. J Arthroplasty. 2012;27(1):31-36.

[20] 张晓岗,阿斯哈尔江•买买提依明,曹力,等.非骨水泥型人工关节置换治疗老年不稳定股骨转子间骨折[J]. 中华骨科杂志, 2012,32(7): 631-636.

[21] 田雅峰,姚兴豹,杨刚,等.经皮外固定架和PFNA治疗老年高危股骨转子间骨折的临床效果[J].中国医药导报, 2018,15(5):122-126.