Department of Orthopaedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, Republic of Korea.
Injury. 2019 Nov;50(11):2045-2048. doi: 10.1016/j.injury.2019.09.010. Epub 2019 Sep 8.
Hip fracture and upper extremity fracture are most important age-related fracture. However, there have been few reports about the analysis of prevalence or risk factors with concomitant hip and upper extremity fractures. This study aimed to describe the prevalence and clinical implications of the concomitant hip and upper extremity fractures in elderly.
We evaluate 1018 patients aged >65 years who were surgically treated for femoral neck or intertrochanteric fractures between March 2008 and December 2018. 35 patients (3.4%) with a hip fracture combined upper extremity fracture. All patients were classified into the isolated hip fracture and the concomitant fracture. We analyzed these patients' characteristics such as age, gender, bone mineral density (BMD), body mass index (BMI), Korean version of Mini-Mental State Examination (MMSE-K), injury mechanism, and length of hospital stay.
The most common site of upper extremity fracture was distal radius fracture of 15 patients (42.8%), followed by proximal humeral fracture of 8 (22.8%). Concomitant fractures occurred on the same side in 30 patients (85.7%). The mean age of patients with a concomitant fracture was younger than that of patients with an isolated hip fracture (p < 0.05). Mean preinjury MMSE-K was 22.7 in isolated hip fracture and 25.6 in concomitant fracture patients (p < 0.05). Mean length of hospital stay was statistically significant different between two groups (p < 0.05). According to fracture site of hip, there was no statistically different prevalence of upper extremity fracture in femoral intertrochanteric fracture compared to the neck fracture.
We found a 3.4% prevalence of concomitant hip and upper extremity fractures. It was found that the younger the age with preserved cognitive ability in elderly patients with a hip fracture, the higher the prevalence of upper extremity fracture. In addition, it is important to keep in mind that patients with a concomitant fracture have a longer hospital stay and difficulty in rehabilitation.
髋部骨折和上肢骨折是最重要的与年龄相关的骨折。然而，关于同时发生髋部和上肢骨折的患病率或危险因素的分析报告很少。本研究旨在描述老年患者同时发生髋部和上肢骨折的患病率和临床意义。
我们评估了 2008 年 3 月至 2018 年 12 月期间接受股骨颈或粗隆间骨折手术治疗的 1018 名年龄>65 岁的患者。其中 35 例（3.4%）患者合并髋部和上肢骨折。所有患者分为单纯髋部骨折组和合并骨折组。我们分析了这些患者的年龄、性别、骨密度（BMD）、体重指数（BMI）、韩国版简易精神状态检查（MMSE-K）、损伤机制和住院时间等特征。
上肢骨折最常见的部位是 15 例（42.8%）远端桡骨骨折，其次是 8 例（22.8%）近端肱骨骨折。30 例（85.7%）合并骨折发生在同侧。合并骨折患者的平均年龄小于单纯髋部骨折患者（p<0.05）。单纯髋部骨折患者的平均术前 MMSE-K 为 22.7，合并骨折患者为 25.6（p<0.05）。两组患者的平均住院时间有统计学差异（p<0.05）。根据髋部骨折部位，股骨粗隆间骨折与股骨颈骨折相比，上肢骨折的患病率无统计学差异。
我们发现同时发生髋部和上肢骨折的患病率为 3.4%。年龄较轻且认知能力保留的老年髋部骨折患者，上肢骨折的患病率越高。此外，合并骨折的患者住院时间较长，康复难度较大，这一点很重要。
