全球下肢骨折流行病学：GBD 2021研究的趋势、负担及预测

Global epidemiology of lower limb fractures: Trends, burden, and projections from the GBD 2021 study.

作者信息

Wang Yunfa, Wang Zhilin, Chen Bin, Chen Bofan, Fang Ruiying, Zeng Haimin, Peng Jie, Gao Yuan, Hao Liang

机构信息

Department of Orthopedics, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, NO. 1 Minde Road, Nanchang, Jiangxi, China.

Department of Orthopedics, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, NO. 1 Minde Road, Nanchang, Jiangxi, China; Institute of Orthopedics of Jiangxi Province, Nanchang, Jiangxi 330006, China; Jiangxi Provincial Key Laboratory of Spine and Spinal Cord Disease, Jiangxi 330006, China; Institute of Minimally Invasive Orthopedics, Nanchang University, Jiangxi 330006, China.

出版信息

Bone. 2025 Apr;193:117420. doi: 10.1016/j.bone.2025.117420. Epub 2025 Jan 31.

DOI:10.1016/j.bone.2025.117420

PMID:39894291

Abstract

BACKGROUND

Lower limb fractures are a significant global public health issue, imposing considerable social and economic burdens. Despite their prevalence, comprehensive analyses of the global epidemiology of lower limb fractures remain scarce. This study aims to address this gap.

METHODS

Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we analyzed four types of lower limb fractures: fractures of foot bones excluding the ankle (FFB), hip fractures (FH), fractures of the patella, tibia or fibula, or ankle (FPTFA), and femur fractures excluding the femoral neck (FF), and conducted a detailed assessment of them.

RESULTS

FPTFA was the most burdensome fracture type, with Slovenia showing the highest age-standardized incidence rate (ASIR), and Saudi Arabia having the highest age-standardized prevalence rate (ASPR) and years lived with disability rate (ASYR). The burden of lower limb fractures increased with age, but FFB and FPTFA showed a "double peak" age distribution, with FFB most common in the 20-24 age group. Lower limb fractures were more prevalent in males among younger individuals and in females among older populations. From 1990 to 2021, the burden of lower limb fractures, excluding FH, decreased (EAPC <1), though the incidence of FF is projected to increase (EAPC = 0.14, 95 % CI 0.1-0.18) over the next decade.

CONCLUSION

Although the global burden of lower limb fractures, excluding FH, has decreased in recent years, vigilance is still needed. Given the projected rise in FF incidence over the next decade, preventive measures should be implemented early.

摘要

背景

下肢骨折是一个重大的全球公共卫生问题，带来了相当大的社会和经济负担。尽管其普遍存在，但对全球下肢骨折流行病学的全面分析仍然匮乏。本研究旨在填补这一空白。

方法

利用全球疾病、伤害及风险因素负担研究（GBD）2021的数据，我们分析了四种类型的下肢骨折：不包括踝关节的足部骨折（FFB）、髋部骨折（FH）、髌骨、胫骨或腓骨或踝关节骨折（FPTFA）以及不包括股骨颈的股骨骨折（FF），并对它们进行了详细评估。

结果

FPTFA是负担最重的骨折类型，斯洛文尼亚的年龄标准化发病率（ASIR）最高，沙特阿拉伯的年龄标准化患病率（ASPR）和伤残调整生命年率（ASYR）最高。下肢骨折的负担随年龄增加，但FFB和FPTFA呈现“双峰”年龄分布，FFB在20 - 24岁年龄组最为常见。下肢骨折在年轻个体中男性更为普遍，在老年人群中女性更为普遍。从1990年到2021年，不包括FH的下肢骨折负担有所下降（EAPC<1），不过预计在未来十年FF的发病率将会上升（EAPC = 0.14，95%CI 0.1 - 0.18）。