Brinker Mark R, O'Connor Daniel P
The Center for Musculoskeletal Research and Outcome Studies, Fondren Orthopedic Group, and Joe W. King Orthopedic Institute, Texas Orthopedic Hospital, 7401 South Main Street, Houston, TX 77030, USA.
J Bone Joint Surg Am. 2004 Feb;86(2):290-7.
The purpose of this study was to determine the annual incidence rates of non-work-related traumatic fractures and dislocations (excluding head and facial injuries) referred for orthopaedic services in a large population enrolled under a capitated insurance contract.
The number of fractures and dislocations that were referred for orthopaedic services were recorded prospectively from among an average of 135,333 persons per year who were enrolled under a capitated insurance contract during the three-year study period. These data were used to determine the gender-specific and age-specific incidence rates of fractures and dislocations referred for orthopaedic services.
A total of 3440 fractures and 422 dislocations were referred for orthopaedic services during the three-year study period. The incidence rate of fractures referred for orthopaedic services was 8.47 per 1000 member-years, with a significantly (p < 0.0001) higher rate among males. Members between the ages of ten and fourteen years had the highest rate of fractures referred for orthopaedic services (21.52 per 1000 member-years). The lifetime risk of a traumatic fracture referred for orthopaedic services to the age of sixty-five years was one in two for both males and females. The incidence rate of dislocations referred for orthopaedic services was 1.04 per 1000 member-years, which did not differ significantly (p = 0.75) between genders. Members between the ages of fifteen and nineteen years had the highest rate of dislocations referred for orthopaedic services (2.75 per 1000 member-years). The lifetime risk of a traumatic dislocation referred for orthopaedic services to the age of sixty-five years was one in sixteen for both male and female members.
Young males had the highest rate of traumatic fractures referred for orthopaedic services. Adolescents of both genders had high rates of traumatic dislocations referred for orthopaedic services. The lifetime risk of a non-work-related fracture referred for orthopaedic services to the age of sixty-five years is approximately equal to that of coronary artery disease.
本研究的目的是确定在参加按人头付费保险合同的大量人群中，因非工作相关创伤性骨折和脱位（不包括头部和面部损伤）而转诊至骨科治疗的年发病率。
在为期三年的研究期间，前瞻性记录每年平均135333名参加按人头付费保险合同的人员中转诊至骨科治疗的骨折和脱位数量。这些数据用于确定因转诊至骨科治疗的骨折和脱位的性别和年龄特异性发病率。
在为期三年的研究期间，共有3440例骨折和422例脱位转诊至骨科治疗。因转诊至骨科治疗的骨折发病率为每1000成员年8.47例，男性发病率显著更高（p<0.0001）。10至14岁的成员因转诊至骨科治疗的骨折发病率最高（每1000成员年21.52例）。到65岁时，因转诊至骨科治疗的创伤性骨折的终生风险在男性和女性中均为二分之一。因转诊至骨科治疗的脱位发病率为每1000成员年1.04例，两性之间无显著差异（p = 0.75）。15至19岁的成员因转诊至骨科治疗的脱位发病率最高（每1000成员年2.75例）。到65岁时，因转诊至骨科治疗的创伤性脱位的终生风险在男性和女性成员中均为十六分之一。
年轻男性因转诊至骨科治疗的创伤性骨折发病率最高。两性青少年因转诊至骨科治疗的创伤性脱位发病率均较高。到65岁时，因转诊至骨科治疗的非工作相关骨折的终生风险与冠状动脉疾病的终生风险大致相等。
