Hemmann Philipp, Friederich Maximilian, Bahrs Christian, Jacoby Johann, Körner Daniel
Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstr. 95, 72076, Tuebingen, Germany.
Eberhard Karls University Tuebingen, Tuebingen Medical School, Geissweg 5, 72076, Tuebingen, Germany.
Arch Orthop Trauma Surg. 2022 Aug;142(8):1847-1857. doi: 10.1007/s00402-021-03874-4. Epub 2021 Apr 12.
The aim of this study was to present recent epidemiological data on extremity and axial skeletal fractures in German hospitals and to compare them with older data to detect time trends.
Inpatient data from the German National Hospital Discharge Registry were used. The absolute number and age-standardized incidence of fractures in 2002 and 2018 were analysed by fracture location according to the International Classification of Disease. Data were analysed according to age group. Male: female ratios (MFRs) and incidence rate ratios (IRRs) were calculated to compare the 2018 and 2002 data.
The absolute number of fractures of the nine analysed locations was 15.2% higher in 2018 than in 2002. By fracture location, the changes were as follows (absolute change + IRR): "neck" (S12): + 172%, IRR = 2.6; "rib(s), sternum, thoracic spine" (S22): + 57%, IRR = 1.3; "lumbar spine and pelvis" (S32): + 66%, IRR = 1.3; "shoulder and upper arm" (S42): + 36%, IRR = 1.2; "forearm" (S52): + 13%, IRR = 1.0; "wrist and hand level" (S62): - 32%, IRR = 0.7; "femur" (S72): + 24%, IRR = 0.9; "lower leg, including ankle" (S82): - 24%, IRR = 0.7; "foot, except ankle" (S92): - 4%, IRR = 0.9. The overall MFR changed from 0.7 in 2002 to 0.6 in 2018. The age group of 45-54 years represented a turning point, males were more often affected than females in the younger age groups, and the opposite trend was observed in the older age groups.
The increase in the absolute fracture rates was due to increased rates of femur, shoulder, upper arm, forearm, and axial skeletal fractures, with elderly women being the main contributors. Femur fractures were found to be the most common fractures treated in German hospitals.
本研究的目的是呈现德国医院四肢和躯干骨骼骨折的最新流行病学数据，并将其与早期数据进行比较，以发现时间趋势。
使用来自德国国家医院出院登记处的住院患者数据。根据国际疾病分类，按骨折部位分析了2002年和2018年骨折的绝对数量和年龄标准化发病率。数据按年龄组进行分析。计算了男性与女性比例（MFR）和发病率比（IRR），以比较2018年和2002年的数据。
2018年九个分析部位的骨折绝对数量比2002年高15.2%。按骨折部位，变化如下（绝对变化+IRR）：“颈部”（S12）：增加172%，IRR=2.6；“肋骨、胸骨、胸椎”（S22）：增加57%，IRR=1.3；“腰椎和骨盆”（S32）：增加66%，IRR=1.3；“肩部和上臂”（S42）：增加36%，IRR=1.2；“前臂”（S52）：增加13%，IRR=1.0；“腕部和手部水平”（S62）：减少32%，IRR=0.7；“股骨”（S72）：增加24%，IRR=0.9；“小腿，包括脚踝”（S82）：减少24%，IRR=0.7；“足部，不包括脚踝”（S92）：减少4%，IRR=0.9。总体MFR从2002年的0.7变为2018年的0.6。45-54岁年龄组是一个转折点，在较年轻年龄组中男性比女性更常受影响，而在较年长年龄组中观察到相反的趋势。
骨折绝对发生率的增加是由于股骨、肩部、上臂、前臂和躯干骨骼骨折发生率的增加，老年女性是主要贡献者。股骨骨折是德国医院治疗的最常见骨折。
