Hey Hwee Weng Dennis, Chong Alphonsus Khin Sze, Murphy Diarmuid
Departments of Orthopaedic Surgery and Hand and Reconstructive Microsurgery, National University Hospital, Singapore.
J Hand Surg Am. 2011 Feb;36(2):278-83. doi: 10.1016/j.jhsa.2010.11.009.
To determine the prevalence of carpal fracture in Singapore, to compare demographic differences between isolated scaphoid and other carpal fractures, and to identify parameters associated with multiple carpal fractures.
A total of 149 patients with 162 carpal fractures seen at the National University Hospital in 2009 were enrolled into the study. We retrospectively reviewed their case records and radiographic studies. Pertinent demographic data including patient age, gender, occupation, injured wrist, dominant hand, mechanism of injury, and type of carpal fracture were then recorded and statistically analyzed. We also performed a separate analysis of isolated scaphoid versus other carpal fractures and single versus multiple carpal fractures.
Patients with carpal fracture were predominantly male (132), below 40 years of age (116), and usually right hand dominant (136). The more common occupations were students (30), full-time military national servicemen (24), and construction workers (14). Most presented after a fall on an outstretched hand from standing height (81). The scaphoid was the most common single carpal fracture (99). This was followed by triquetrum (27), hamate (5), pisiform (4), lunate (2), capitate (1), and trapezium (1). No fracture of the trapezoid was encountered. Ten patients had multiple carpal fractures, of which 4 were perilunate fracture dislocations. The mean age and male/female ratio for isolated scaphoid and other carpal fractures was 26 years versus 41 years (p<.001) and 13:1 versus 4:1 (p=.036), respectively. A high-energy mechanism of injury was the only parameter associated with multiple carpal fractures (p=.009).
The prevalence of carpal fracture in our population was consistent with studies performed in other countries. Military conscription was identified as an at-risk activity predisposing to carpal fracture. Isolated scaphoid and other carpal fractures exhibit different demographics in terms of age and gender, which may be related to differences in the mechanism of injury. A high-energy mechanism of injury was associated with multiple carpal fractures.
确定新加坡腕骨骨折的患病率，比较孤立舟状骨骨折与其他腕骨骨折之间的人口统计学差异，并确定与多发性腕骨骨折相关的参数。
2009年在国立大学医院就诊的149例患者共发生162例腕骨骨折，纳入本研究。我们回顾性地查阅了他们的病例记录和影像学检查。记录包括患者年龄、性别、职业、受伤手腕、优势手、损伤机制和腕骨骨折类型等相关人口统计学数据，并进行统计分析。我们还分别对孤立舟状骨骨折与其他腕骨骨折以及单发性与多发性腕骨骨折进行了分析。
腕骨骨折患者以男性为主（132例），年龄在40岁以下（116例），通常优势手为右手（136例）。较常见的职业是学生（30例）、全职义务兵（24例）和建筑工人（14例）。大多数患者是从站立高度伸手跌倒后就诊（81例）。舟状骨是最常见的单发性腕骨骨折（99例）。其次是三角骨（27例）、钩骨（5例）、豌豆骨（4例）、月骨（2例）、头状骨（1例）和大多角骨（1例）。未遇到梯形骨骨折。10例患者有多发性腕骨骨折，其中4例为月骨周围骨折脱位。孤立舟状骨骨折和其他腕骨骨折的平均年龄和男女比例分别为26岁对41岁（p<0.001）和13:1对4:1（p = 0.036）。高能量损伤机制是与多发性腕骨骨折相关的唯一参数（p = 0.009）。
我们人群中腕骨骨折的患病率与其他国家的研究结果一致。义务兵役被确定为易导致腕骨骨折的高危活动。孤立舟状骨骨折和其他腕骨骨折在年龄和性别方面表现出不同的人口统计学特征，这可能与损伤机制的差异有关。高能量损伤机制与多发性腕骨骨折相关。
