Wang Michael T, Yao Sarah H, Wong Phillip, Trinh Anne, Ebeling Peter R, Tran Ton, Milat Frances, Mutalima Nora
Monash School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia.
Department of Endocrinology, Monash Health, Clayton, Australia.
Arch Osteoporos. 2017 Dec;12(1):46. doi: 10.1007/s11657-017-0339-y. Epub 2017 May 4.
This study characterises risk factors, complications and follow-up of minimal trauma hip fractures in young adults, adding to limited information examining the management framework. This group have severe systemic disease and significant risk of post-operative complications and subsequent fractures. Improved medical referral pathways enable management of osteoporosis and comorbid diseases.
There is a paucity of literature examining minimal trauma hip fractures in young adults, despite extensive management guidelines for older patients. This study aims to characterise risk factors, complications and follow-up of hip fractures to guide management pathways.
This is a retrospective study of patients presenting with hip fracture to a single institution from 2009 to 2015. Hip fractures were identified using ICD-10 codes and clinical information documented from medical records. Patients were categorised into minimal trauma (MTF) and high-energy fracture (HEF) groups based on mechanism of injury.
Of 2512 patients admitted with hip fracture, 2.5% (n = 62) were aged 15-49 years. Two patients were excluded with pathological fractures, and seven were excluded with no recorded mechanism of injury. MTF occurred in 43 patients and 10 sustained HEF. These groups had similar demographics, fracture locations and treatments. The MTF group had higher American Society of Anaesthesiologists scores (MTF 2.44 ± 0.9; HEF 1.43 ± 0.5; p = 0.025) and higher rates of chronic endocrine disease (MTF 34.9%; HEF 0%; p = 0.046). Rates of post-operative surgical (MTF 24.0%; HEF 12.5%) and medical complications (MTF 27.8%; HEF 12.5%) were high in MTF patients. Subsequent fractures occurred in five (13.9%) MTF patients during the study period compared with none in the HEF group. Only 16 (44.4%) of the MTF patients were referred to endocrine care.
Young adults with MTF of the hip have more severe systemic disease and are at risk of post-operative complications and subsequent fractures. Referral of patients to endocrine care is recommended to manage osteoporosis and comorbid diseases.
本研究对年轻成年人微创髋部骨折的危险因素、并发症及随访情况进行了特征描述，补充了关于治疗框架的有限信息。该群体患有严重的全身性疾病，术后并发症及后续骨折风险较高。改善医疗转诊途径有助于骨质疏松症及合并疾病的管理。
尽管针对老年患者有广泛的治疗指南，但关于年轻成年人微创髋部骨折的文献却很少。本研究旨在描述髋部骨折的危险因素、并发症及随访情况，以指导治疗途径。
这是一项对2009年至2015年在单一机构就诊的髋部骨折患者的回顾性研究。使用ICD - 10编码和病历中记录的临床信息来识别髋部骨折。根据损伤机制将患者分为微创骨折（MTF）组和高能骨折（HEF）组。
在2512例因髋部骨折入院的患者中，2.5%（n = 62）年龄在15 - 49岁之间。2例病理性骨折患者被排除，7例无损伤机制记录的患者被排除。43例患者发生微创骨折，10例发生高能骨折。这两组在人口统计学、骨折部位和治疗方法上相似。微创骨折组美国麻醉医师协会评分更高（MTF 2.44 ± 0.9；HEF 1.43 ± 0.5；p = 0.025），慢性内分泌疾病发生率更高（MTF 34.9%；HEF 0%；p = 0.046）。微创骨折患者术后手术并发症（MTF 24.0%；HEF 12.5%）和医疗并发症（MTF 27.8%；HEF 12.5%）发生率较高。在研究期间，5例（13.9%）微创骨折患者发生了后续骨折，而高能骨折组无此情况。只有16例（44.4%）微创骨折患者被转诊至内分泌科治疗。
年轻成年人髋部微创骨折患者患有更严重的全身性疾病，有术后并发症及后续骨折风险。建议将患者转诊至内分泌科治疗以管理骨质疏松症及合并疾病。
