Chen Wei, Zhu Yanbin, Liu Song, Hou Zhiyong, Zhang Xiaolin, Lv Hongzhi, Zhang Yingze
Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, Hebei, 050051, People's Republic of China.
Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, People's Republic of China.
Int Orthop. 2018 Mar;42(3):651-658. doi: 10.1007/s00264-018-3815-0. Epub 2018 Feb 5.
This study aims to investigate the population-based incidence of clavicle fracture and the related risk factors in China.
All the data on clavicle fractures were available from the China National Fracture Survey (CNFS) database performed in 2015. In the CNFS, all eligible household members were sampled from eight provinces, 24 urban cities, and 24 rural counties in China, using stratified random sampling and the probability proportional to size method. Questionnaires were sent to every participant for data collection. Information on age, gender, height, weight, ethnic group, education, professional, smoking, alcohol consumption, sleeping time per day, dietary habits, and others was collected. Fracture case was identified by patients' self report and further confirmation by medical data.
A total of 512,187 valid questionnaires were collected, and relevant data were extracted and analyzed. There were 89 patients with 89 clavicle fractures in 2014, indicating that the incidence was 17.4 (95%CI, 13.8-21.0) per 100,000 person-years. Traffic accidents and falls were the most predominant cause for clavicle factures, leading to 91.0% of all the injuries. Over 85% of them occurred on the road and at home. Age of 45-64, average sleep time < seven hours/day, smoking, alcohol consumption and history of previous fracture were identified as independent risk factors for clavicle fracture. Overweight (BMI, 24.0-27.9) was a significant protective factor, which was estimated to reduce 72% of the clavicle fractures, compared to normal BMI (18.5-23.9).
Public health policies focusing on decreasing alcohol consumption, smoking cessation, and encouraging individuals to obtain sufficient sleep should be implemented. Middle-aged individuals with previous history of fracture should strengthen the awareness of prevention and health care and decrease risky activities to reduce the clavicle fractures.
本研究旨在调查中国人群中锁骨骨折的发病率及相关危险因素。
所有锁骨骨折数据均来自2015年开展的中国国家骨折调查(CNFS)数据库。在CNFS中,采用分层随机抽样和规模比例概率法,从中国8个省份、24个城市和24个农村县抽取所有符合条件的家庭成员。向每位参与者发放问卷以收集数据。收集了年龄、性别、身高、体重、民族、教育程度、职业、吸烟、饮酒、每日睡眠时间、饮食习惯等信息。骨折病例通过患者自我报告确定,并经医疗数据进一步确认。
共收集到512,187份有效问卷,并提取和分析了相关数据。2014年有89例患者发生89例锁骨骨折,发病率为每10万人年17.4例(95%CI,13.8 - 21.0)。交通事故和跌倒为锁骨骨折最主要的原因,占所有损伤的91.0%。其中超过85%发生在道路上和家中。45 - 64岁、平均每日睡眠时间<7小时、吸烟、饮酒及既往骨折史被确定为锁骨骨折的独立危险因素。超重(BMI,24.0 - 27.9)是一个显著的保护因素,与正常BMI(18.5 - 23.9)相比,估计可减少72%的锁骨骨折。
应实施侧重于减少饮酒、戒烟及鼓励个人获得充足睡眠的公共卫生政策。有既往骨折史的中年个体应加强预防和保健意识,减少危险活动以降低锁骨骨折发生率。