尺骨鹰嘴骨折的流行病学与治疗：基于丹麦全国登记系统对1999年至2018年27880例病例的分析

Epidemiology and Treatment of Olecranon Fractures: a nationwide register-based analysis of 27,880 cases in Denmark from 1999 to 2018.

作者信息

Zeyghami Walid, Karimi Dennis, Hagemann William M, Gundtoft Per H, Viberg Bjarke, Maleitzke Tazio

机构信息

Department of Orthopaedic Surgery, Trauma Orthopaedic Research Copenhagen Hvidovre (TORCH), Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark.

Department of Orthopaedic Surgery, Copenhagen University Hospital - Zealand University Hospital Køge, Køge, Denmark.

出版信息

J Orthop Surg Res. 2025 Jun 3;20(1):561. doi: 10.1186/s13018-025-05970-2.

DOI:10.1186/s13018-025-05970-2

PMID:40462203

Abstract

BACKGROUND

Olecranon fractures (OFs) account for approximately 20% of proximal forearm fractures. Displaced or unstable OFs are typically treated surgically with tension-band wiring (TBW) or plate fixation (PF). While comparative works on surgical OF management exist, epidemiological studies are limited by short time spans and small sample sizes. This study investigates OF incidence rates (IRs), and treatment trends in Denmark over a 20-year period from 1999 to 2018.

PATIENTS AND METHODS

Population-based Danish National Patient Register study on OFs in adult patients from 1999 to 2018. Patients ≥ 20 years diagnosed with OF (ICD-10: S520) were included. Age, sex, and treatment were recorded. Treatment was classified as surgical if relevant surgical procedure codes were recorded within 21 days of OF diagnosis. In the absence of such codes, treatment was classified as non-surgical.

RESULTS

A total of 27,880 OF cases (61% female) were identified between 1999 and 2018. The overall mean IR was 33/100,000/year, increasing from 31 in 1999 to 40 in 2018. Females and males had similar IRs between 20 and 49 years, while females ≥ 50 years showed markedly higher IRs than males. Non-surgical treatment was predominant (67%, range: 64-72%). Surgical treatment was more frequent in females (36%, range: 30-42%) than in males (28%, range: 25-34%) and more frequent in patients ≥ 50 years (37%, range: 32-41%) than in patients < 50 years (24%, range: 22-26). Interestingly, from 2013 onwards, surgical treatment decreased in patients ≥ 70 years. Over time, PF use increased from 7% in 1999 to 45% in 2018. TBW declined from 89% in 1999 to 46% in 2018.

CONCLUSIONS

The incidence of OFs increased by 29% over the 20-year study period. Non-surgical treatment was predominant across all ages but decreased markedly in older patients. Over the assessed two decades, PF increased and TBW decreased in popularity for surgically managed OFs. Studies identifying which patients may benefit most from surgical and non-surgical treatment by incorporating patient-specific factors will help to refine decision-making and optimize clinical outcomes.

摘要

背景

尺骨鹰嘴骨折（OFs）约占前臂近端骨折的20%。移位或不稳定的尺骨鹰嘴骨折通常采用张力带钢丝固定（TBW）或钢板固定（PF）进行手术治疗。虽然存在关于手术治疗尺骨鹰嘴骨折的比较研究，但流行病学研究受限于时间跨度短和样本量小。本研究调查了1999年至2018年丹麦20年间尺骨鹰嘴骨折的发病率（IRs）和治疗趋势。

患者与方法

基于丹麦国家患者登记处的研究，纳入1999年至2018年成年患者的尺骨鹰嘴骨折病例。纳入年龄≥20岁、诊断为尺骨鹰嘴骨折（国际疾病分类第十版：S520）的患者。记录年龄、性别和治疗情况。如果在尺骨鹰嘴骨折诊断后21天内记录了相关手术操作代码，则将治疗分类为手术治疗。如果没有此类代码，则将治疗分类为非手术治疗。

结果

1999年至2018年共识别出27,880例尺骨鹰嘴骨折病例（61%为女性）。总体平均发病率为每年33/100,000，从1999年的31上升至2018年的40。20至49岁的女性和男性发病率相似，而≥50岁的女性发病率明显高于男性。非手术治疗占主导（67%，范围：64 - 72%）。女性的手术治疗频率（36%，范围：30 - 42%）高于男性（28%，范围：25 - 34%），≥50岁患者的手术治疗频率（37%，范围：32 - 41%）高于<50岁患者（24%，范围：22 - 26%）。有趣的是，从2013年起，≥70岁患者的手术治疗有所减少。随着时间的推移，钢板固定的使用从1999年的7%增加到2018年的45%。张力带钢丝固定从1999年的89%下降到2018年的46%。

结论

在20年的研究期内，尺骨鹰嘴骨折的发病率增加了29%。非手术治疗在所有年龄段中占主导，但在老年患者中明显减少。在评估的二十年中，对于手术治疗的尺骨鹰嘴骨折，钢板固定的应用增加，张力带钢丝固定的应用减少。通过纳入患者特定因素来确定哪些患者可能从手术和非手术治疗中获益最大的研究，将有助于优化决策并改善临床结果。