30 年来髋部骨折的影像学严重程度趋势：一项队列研究。

The trend of radiological severity of hip fractures over a 30 years period: a cohort study.

机构信息

Department of Surgical and Perioperative Sciences, Umeå University, 90187, Umeå, Sweden.

出版信息

BMC Musculoskelet Disord. 2019 Aug 7;20(1):358. doi: 10.1186/s12891-019-2739-1.

DOI:10.1186/s12891-019-2739-1

PMID:31391031

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6686553/

Abstract

BACKGROUND

Despite advances in operative techniques and preoperative care, proximal femur fractures (PFF) still represent a great public health problem. Displacement and fracture stability have been assumed as important determinants of treatment modality and outcome in such fractures. Purpose of this study was to determine whether the radiological severity of PFF fractures has increased over time.

METHODS

In a cohort study, the plain radiographs of all patients with PFF aged over 50 years who were admitted to Umeå University Hospital in 1981/82, 2002 and 2012 were recruited to examine the types of fractures.

RESULTS

The ratio of undisplaced to displaced femoral neck (FN) fractures was 30 to 70% in 1981/82, 28 to 72% in 2002 and 25 to 75% in 2012. The ratio of stable to unstable intertrochanteric (IT) fractures was 64 to 36% in 1981/82, 68 to 32% in 2002 and 75 to 25% in 2012. The ratio of simple to comminute subtrochanteric fractures was 35 to 65% in 1981/82, 16 to 84% in 2002 and 12 to 88% in 2012. In both FN and IT fractures we found no statistical difference among these 3 study periods, p = 0.67 and p = 0.40. In subtrochanteric fractures we saw a tendency towards more comminute subtrochanteric fractures (1981/82 to 2012), p = 0.09.

CONCLUSIONS

We found no significant increment in the radiological severity of FN and IT over a 30 years' period. However, there was tendency towards an increase in comminute subtrochanteric fractures.

摘要

背景

尽管手术技术和术前护理有所进步，但股骨近端骨折（PFF）仍然是一个重大的公共卫生问题。移位和骨折稳定性被认为是此类骨折治疗方式和结果的重要决定因素。本研究的目的是确定 PFF 骨折的放射学严重程度是否随时间而增加。

方法

在一项队列研究中，招募了在 1981/82 年、2002 年和 2012 年期间因股骨颈（FN）骨折和股骨转子间骨折（IT）而入住于于默奥大学医院的所有 50 岁以上患者的平片，以检查骨折类型。

结果

1981/82 年，无移位 FN 骨折与移位 FN 骨折的比例为 30 比 70%，2002 年为 28 比 72%，2012 年为 25 比 75%。1981/82 年稳定 IT 骨折与不稳定 IT 骨折的比例为 64 比 36%，2002 年为 68 比 32%，2012 年为 75 比 25%。1981/82 年简单型 Subtrochanteric 骨折与粉碎型 Subtrochanteric 骨折的比例为 35 比 65%，2002 年为 16 比 84%，2012 年为 12 比 88%。在 FN 和 IT 骨折中，我们没有发现这 3 个研究期之间的统计学差异，p=0.67 和 p=0.40。在 Subtrochanteric 骨折中，我们发现粉碎性 Subtrochanteric 骨折有增加的趋势（1981/82 年至 2012 年），p=0.09。