Department of Orthopaedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, China.
Department of Orthopedics, Hong Hui Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, China.
Orthop Surg. 2022 Sep;14(9):2132-2140. doi: 10.1111/os.13410. Epub 2022 Aug 5.
Femoral fractures are a common cause of mortality and functional loss, mainly among older people, and there are few studies about the age in relation to traumatic femoral fractures. The aim of this study was to investigate the effect of age on the patterns of traumatic femoral fractures in patients presenting to our regional tertiary hospital.
The records of 2020 patients who presented with traumatic femoral fractures between 2013 and 2019 were retrospectively reviewed. The patients' clinical and radiographic records were reviewed. Univariate and multivariable logistic regression were used to identify independent risk factors for associated injuries and complications.
The patients were divided into a child group (CH group, n = 342) aged under 18 years, a young adult group (YA group, n = 484) aged 18-60 years, and an older people group (OP group, n = 1194) aged 60 years and over. There were significant differences among the three groups in several indexes, such as sex ratio (χ = 301.699, p < 0.001), osteoporosis (χ = 375.463, p < 0.001), injury time of day (χ = 114.913, p < 0.001), injury cause (χ = 748.187, p < 0.001), injury location (χ = 490.153, p < 0.001), fracture side (χ = 57.000, p < 0.001), fracture site (χ = 806.650, p < 0.001), associated injuries (χ = 322.921, p < 0.001), coma after injury (χ = 147.814, p < 0.001), non-surgery-related complications (χ = 7.895, p = 0.019), and surgery-related complications (χ = 82.186, p < 0.001). The YA group had a significantly higher percentage of patients with surgery-related complications than the OP group. The OP group had a higher frequency of non-surgery-related complications than the YA group and CH group. The most common non-surgery-related complications were pneumonia (7.1%) in the OP group and deep venous thrombosis (6.4%) in the YA group. Multivariable logistic regression showed that young adults, high-energy injury, outdoors, coma after injury, and fracture sites except for the proximal region were independent risk factors for associated injuries. Older age, male, and fracture site except for the proximal region were independent risk factors for complications.
Traumatic femoral fractures are mostly the result of low-energy trauma and predominantly affect the proximal site of the femur among older people. A higher rate of shaft fractures, fractures occurring outdoors, and associated injuries were observed among young adults and children than among older people.
股骨骨折是导致死亡和功能丧失的常见原因，主要发生在老年人中，关于与创伤性股骨骨折相关的年龄问题的研究较少。本研究旨在探讨年龄对我院收治的创伤性股骨骨折患者骨折模式的影响。
回顾性分析 2013 年至 2019 年间因创伤性股骨骨折就诊的 2020 例患者的病历。回顾患者的临床和影像学记录。采用单因素和多因素逻辑回归分析确定与损伤和并发症相关的独立危险因素。
患者分为儿童组（CH 组，n=342），年龄<18 岁；青年组（YA 组，n=484），年龄 18-60 岁；老年组（OP 组，n=1194），年龄 60 岁及以上。三组之间存在明显差异，如性别比（χ ²=301.699，p<0.001）、骨质疏松症（χ ²=375.463，p<0.001）、一天中的受伤时间（χ ²=114.913，p<0.001）、受伤原因（χ ²=748.187，p<0.001）、受伤部位（χ ²=490.153，p<0.001）、骨折侧（χ ²=57.000，p<0.001）、骨折部位（χ ²=806.650，p<0.001）、合并伤（χ ²=322.921，p<0.001）、受伤后昏迷（χ ²=147.814，p<0.001）、非手术相关并发症（χ ²=7.895，p=0.019）和手术相关并发症（χ ²=82.186，p<0.001）。与 OP 组相比，YA 组的手术相关并发症发生率明显更高。OP 组的非手术相关并发症发生率高于 YA 组和 CH 组。最常见的非手术相关并发症是 OP 组的肺炎（7.1%）和 YA 组的深静脉血栓形成（6.4%）。多因素逻辑回归显示，年轻人、高能损伤、户外活动、受伤后昏迷以及除近端部位以外的骨折部位是合并伤的独立危险因素。高龄、男性和除近端部位以外的骨折部位是并发症的独立危险因素。
创伤性股骨骨折主要由低能量创伤引起，老年人主要影响股骨近端部位。与老年人相比，年轻人和儿童中更常见股骨干骨折、户外活动中发生的骨折以及合并伤。
