Schmitt Sonja, Krinner Sebastian, Langenbach Andreas, Hennig Friedrich F, Schulz-Drost Stefan
Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Germany.
Department of Pediatric Surgery, University Hospital Erlangen, Germany.
Thorac Cardiovasc Surg. 2018 Nov;66(8):670-677. doi: 10.1055/s-0037-1607305. Epub 2017 Oct 27.
Sternum fractures (SFs) are described as a rare entity of bony fractures. Various accident mechanisms may cause SF such as the direct impact of traffic accidents and also by indirect mechanisms within the framework of falls. Osteoporotic fractures also play an increasing role in SF, but no reliable data on the age distribution of SF in a representative collective have been published so far.
The age distribution of all inpatients treated with SF (S22.2) in Germany from 2005 to 2012 using diagnosis-related group-based routine data was evaluated. Various accident statistics are included in the interpretation of age peaks.
A total of 47,893 patients (24,960 as main diagnosis and 22,933 as secondary diagnosis) were included in the study. SF is a rarity in childhood, with a share of 1.83% before the age of 16 years, followed by a sudden increase in the frequency up to the age of 20 years. A decrease in the frequency is observed up to the age of 35 years before it increases again to the age of 75 years. Three age peaks can be observed at 18, 55, and 75 years. Those who are older than 65 years account for 43.3% of total SF.
The first age summit after the age of 16 years shows an identical course to the frequency of traffic accidents of this age group, as well as the decline to the fourth decade and the subsequent resurgence up to the fifth decade. After 65 years, the incidence of accidents increases, in particular, the risk of falling in elderly people. In the context of a weaker bone structure, low falls are a common course for fragility fractures. The present analysis of routines shows for the first time the age distribution of the SF taking into account all hospital cases of the observation period.
胸骨骨折（SFs）被描述为一种罕见的骨折类型。多种事故机制可能导致胸骨骨折，如交通事故的直接撞击，以及跌倒情况下的间接机制。骨质疏松性骨折在胸骨骨折中也发挥着越来越重要的作用，但迄今为止，尚未有关于具有代表性人群中胸骨骨折年龄分布的可靠数据发表。
利用基于诊断相关组的常规数据，对2005年至2012年在德国接受胸骨骨折（S22.2）治疗的所有住院患者的年龄分布进行评估。在对年龄峰值的解读中纳入了各种事故统计数据。
本研究共纳入47893例患者（24960例为主诊断，22933例为次诊断）。胸骨骨折在儿童期较为罕见，16岁之前的占比为1.83%，随后在20岁之前频率突然增加。在35岁之前频率下降，之后在75岁之前再次上升。在18岁、55岁和75岁时可观察到三个年龄峰值。65岁以上的患者占胸骨骨折总数的43.3%。
16岁之后的第一个年龄高峰与该年龄组交通事故的频率变化趋势相同，以及到第四个十年的下降和随后到第五个十年的再次上升。65岁之后，事故发生率增加，尤其是老年人跌倒的风险。在骨骼结构较弱的情况下，轻微跌倒通常会导致脆性骨折。本常规分析首次展示了考虑观察期内所有医院病例的胸骨骨折年龄分布情况。
