Larsen Michael Houlind, Gundtoft Per Hviid, Viberg Bjarke
Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark; Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital - University Hospital of Southern Denmark, Denmark.
Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital - University Hospital of Southern Denmark, Denmark; Department of Orthopaedic Surgery and Traumatology, Aarhus University Hospital, Denmark.
Injury. 2025 Mar;56(3):112176. doi: 10.1016/j.injury.2025.112176. Epub 2025 Jan 20.
Proximal femoral fractures has been associated with high mortality risk, while little is known about more distal lower extremity fractures. The aim was to report 30- and 365-days mortality in surgically treated lower extremity fractures in individuals above 65 years.
We extracted data from the Danish National Patient Register on all surgically treated lower extremity fracture in the period 1998-2017. The primary outcome was mortality reported by fracture site defined by ICD-10 codes (femur S72*, tibia S82*, foot/ankle S92*S825-8). The secondary outcomes were mortality divided on sex, age groups (5-year span), and comorbidity. This study was conducted using descriptive statistics.
We identified 182,013 operatively treated lower extremity fractures of which 73 % occurred in females. The 30-day mortality was 10 % for patients with femoral fractures, 2 % for tibia and 1 % for foot/ankle. The 30-day mortality were similar in femoral fractures regardless of location in the femur (8-11 %). The 365-day mortality was 29 % for femoral fractures, 8 % for tibia and 6 % for foot/ankle. Men with a femoral fracture had higher mortality (15 % at 30 days, 37 % at 356 days) in comparison to women (8.2 % at 30 days, 26 % at 356 days). For the above 85+ year age group, the fracture location was less important for 365-day mortality.
There was an observed high risk of mortality in surgically treated femoral fractures. The mortality risks seems to rapidly decline when the fractures are below the knee.
股骨近端骨折与高死亡风险相关，而对于更靠近下肢远端的骨折了解甚少。本研究旨在报告65岁以上接受手术治疗的下肢骨折患者30天和365天的死亡率。
我们从丹麦国家患者登记处提取了1998年至2017年期间所有接受手术治疗的下肢骨折数据。主要结局是根据国际疾病分类第10版（ICD - 10）编码（股骨S72*、胫骨S82*、足/踝S92*S825 - 8）定义的骨折部位报告的死亡率。次要结局是按性别、年龄组（5年跨度）和合并症划分死亡率。本研究采用描述性统计方法。
我们确定了182,013例接受手术治疗的下肢骨折，其中73%发生在女性患者中。股骨骨折患者的30天死亡率为10%，胫骨骨折患者为2%，足/踝骨折患者为1%。无论股骨骨折位于股骨的哪个位置，其30天死亡率相似（8% - 11%）。股骨骨折患者的365天死亡率为29%，胫骨骨折患者为8%，足/踝骨折患者为6%。与女性（30天为8.2%，356天为26%）相比，股骨骨折男性患者的死亡率更高（30天为15%，356天为37%）。对于85岁及以上年龄组，骨折部位对365天死亡率的影响较小。
观察到接受手术治疗的股骨骨折患者存在较高的死亡风险。当骨折位于膝关节以下时，死亡风险似乎迅速下降。
