Epidemiological characteristics of 1 638 patients with femoral intertrochanteric fractures in Hohhot

doi:10.3969/j.issn.2095-4344.2017.16.002

Abstract

Abstract:

BACKGROUND: Femoral intertrochanteric fractures are closely related to sex, age, geographical environment and race. But there is a lack of epidemiology studies on femoral intertrochanteric fractures in the Inner Mongolia Autonomous Region.
OBJECTIVE: To investigate the epidemiological features of femoral intertrochanteric fractures in Hohhot.
METHODS: The clinical data of 1 638 patients with femoral intertrochanteric fractures admitted in four hospitals of Hohhot from May 2008 to April 2015, including their age, gender, the etiology, time of injury, fracture types, were collected and reviewed retrospectively, and the distribution of the epidemiological characteristics were described.

RESULTS AND CONCLUSION: Patients aged 70-79 years accounted for 27.35%, which was the highest in all groups. The overall proportion of older patients was up to 61.17%, among whom, the number of patients with the age of 75-89 years (33.82%) was the highest, and the number of children was the lowest (6.53%). The number of male patients was higher than that of female patients before the age of 50 years, and there was a small peak incidence in age of 10-19 years, but the number of female patients was more than that of male patients after 50 years (P < 0.05). Falling down became the leading cause of femoral intertrochanteric injury, accounting for 50.16% (P < 0.05); in addition, traffic and high falling injuries were also the major injury causes in male patients. The highest incidence of femoral intertrochanteric fractures occurred in winter (36.75%), while the lowest incidence was found in spring (15.75%). The incidence of femoral intertrochanteric fractures showed the epidemic peak in November, while it was lowest in July. According to the Evans classification, type III was the most common (35.23%), and the proportion of unstable fracture was significantly higher than that of stable fracture (63.74% vs. 36.26%, P < 0.05). 31-A2 fractures accounted for 57.02% in AO classification. To conclude, the distribution of patients with femoral intertrochanteric fractures in Hohhot exhibits certain epidemiological characteristics in the aspects of age, sex, etiology, time of injury, and fracture types.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Femur, Femoral Neck Fractures, Epidemiology, Tissue Engineering

CLC Number:

R318

Ji Hao-yu. Epidemiological characteristics of 1 638 patients with femoral intertrochanteric fractures in Hohhot[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(16): 2467-2471.

Figures/Tables 2

2.1 参与者数量分析纳入患者1 638例，按意向性处理分析，全部进入结果分析。 2.2 年龄和性别分布各年龄段中以70-79岁年龄段患者所占比例最高(27.35%)，60-69岁年龄段患者(14.35%)次之，再其次为80-89岁年龄段患者(13.19%)，以 ≤ 9岁年龄段患者最少(4.39%)，70-79岁年龄组与各年龄组采用χ2检验进行两两比较，差异有显著性意义(P < 0.05)。男性和女性的发病高峰均为70-79岁年龄段，分别占10.01%和17.34%，而女性在60-69岁和80-89岁年龄段患者也比较多。采用联合国世界卫生组织对年龄的划分标准(即≤14岁为儿童，15-44岁为青年人，45-59岁为中年人，60-74岁为年轻老年人，75-89岁为老年人，≥ 90岁为长寿老人)：本组老年人比例高达61.17%，而老年人中以75-89岁老年人最多(33.82%)，儿童人数最少( 6.53%)。男性发病高峰呈现15-44岁、75-89岁两个年龄段，女性发病高峰出现在75-89岁、60-74岁年龄段。χ2检验结果显示，在50岁之前(即儿童和青年人)，男性患者人数多于女性(P < 0.05)，50岁之后，女性患者人数明显多于男性(P < 0.05)，见表1和图1。 2.3 致伤原因分布统计结果显示，股骨转子间骨折的致伤原因分布差异有显著性意义(P < 0.05)，摔倒伤(50.61%)明显高于其他致伤原因，其中女性占36.32%，说明女性股骨转子间骨折的主要受伤机制是摔倒伤。交通伤和坠落伤次之，分别占17.03%和15.69%，但在这两种受伤机制中，男性患者均明显高于女性患者(11.29% vs 6.07%，10.38% vs 5.31%)，差异有显著性意义(P < 0.05)，且从表2可见，摔倒伤、坠落伤和交通伤构成了男性患者的主要受伤机制。 2.4 季节和月份分布根据传统的方法进行季节划分(即2-4月为春季，5-7月为夏季，8-10月为秋季，11-来年1月为冬季)。采用χ2检验显示，冬季发病率最高(36.75%)，其次为秋季(29.49%)，春季发病人数最低(15.75%)，说明秋冬季是股骨转子间骨折的高发季节。见图2。从月份流行趋势特点分析，11月发病人数最高，12月、10月、1月发病人数较高，在夏季5月份有个发病小高峰，7 月发病人数最低。见图3。 2.5 骨折分型分布 2.5.1 Evans分型 1 638例股骨转子间骨折患者按照Evans分型分为：Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型和Ⅴ型。其中，Ⅲ型骨折最多，占35.23%，余下依次为Ⅱ型(27.41%)、Ⅳ型(21.06%)、Ⅰ型(8.85%)、Ⅴ型(7.45%)，且男性和女性患者的高发类型均为Ⅲ型骨折，分别占15.38%和19.84%；统计显示，不稳定性骨折组(Ⅲ型、Ⅳ型和Ⅴ型)为63.74%，稳定性骨折组(Ⅰ型和Ⅱ型)为36.26%，两组相比差异有显著性意义(P < 0.05)，各型男性均少于女性，男性和女性患者构成比差异有显著性意义(P < 0.05)。见图4。 2.5.2 AO分型 AO分型中，31-A2型转子间骨折人数最多(57.02%)，男性和女性患者均以31-A2型为主，分别占25.15% 和31.87%，经χ2检验，31-A2型骨折组明显高于其他两组(P < 0.05)，同样，各组均为女性患者构成比高于男性(P < 0.05)。见图5。"

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