| 老年髋部骨折术后健侧骨折的危险因素分析 |
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Received:June 20, 2021
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| 期刊信息：《中国骨伤》2022年35卷，第4期，第353-356页 |
| DOI：10.12200/j.issn.1003-0034.2022.04.011 |
| 基金项目:浙江省中医药科技计划(编号:2020ZA096) |
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目的: 探讨老年髋部骨折术后健侧骨折的发生率及其相关危险因素为预防再次骨折提供依据。
方法: 回顾分析2012年6月至2017年6月接受髋关节置换术或股骨近端髓内钉固定术治疗的65岁以上股骨颈骨折或转子间骨折452例患者的临床资料,男168例,女284例;年龄65~97(75.5±7.5)岁;股骨颈骨折191例,股骨转子间骨折261例;按照术后健侧髋部是否存在骨折,分为骨折组和无骨折组,记录两组患者性别、年龄、体质量指数、骨折类型、初次治疗方式、骨密度、医疗依从性、术后是否短期谵妄、伤前是否并存内科疾病及末次随访髋关节Harris评分。应用单因素Logostic回归分析筛选出术后健侧骨折的危险因素,再将有统计学意义的危险因素纳入多因素Logostic回归分析,筛选出老年髋部骨折术后健侧骨折的独立危险因素。
结果: 452例患者中42例发生健侧髋部骨折,发生率为9.3%,两次骨折发生相隔时间平均(2.9±2.1)年。单因素Logistic回归分析结果示年龄、骨密度、医疗依从性、术后短期谵妄、伤前合并内科疾病及末次随访髋关节Harris评分差异均有统计学意义(P<0.05)。多因素Logistic分析显示年龄(OR=4.227)、骨密度(OR=4.313)、合并内科疾病(OR=5.616),以及末次随访髋关节Harris评分分级低(OR=3.891),是老年髋部骨折术后健侧骨折的独立危险因素(P<0.05)。
结论: 年龄、骨密度、合并内科疾病以及末次随访髋关节Harris评分分级低是老年髋部骨折术后健侧骨折的主要危险因素,术后3年内要加强内科疾病的治疗,抗骨质疏松,改善髋关节功能,以预防健侧髋部骨折的发生。 |
| [关键词]:老年人 髋骨折 再骨折 危险因素 |
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| Analysis of risk factors of healthy side fracture after hip fracture surgery in the elderly |
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Abstract:
Objective: To investigate the incidence and related risk factors of healthy side fracture after hip fracture surgery in the elderly,so as to provide basis for the prevention of re-fracture.
Methods: The data of 452 patients over 65 years old with femoral neck fracture or intertrochanteric fracture treated with hip arthroplasty or proximal femoral intramedullary nailing from June 2012 to June 2017 were analyzed,including 168 males and 284 females,the age ranged from 65 to 97(75.5±7.5) years. There were 191 cases of femoral neck fracture and 261 cases of femoral intertrochanteric fracture. According to whether there was a fracture in the healthy hip after operation,the patients were divided into fracture group and no fracture group. The gender,age,body mass index,fracture type,initial treatment method,bone mineral density,bed time,medical compliance,postoperative short-term delirium,whether there were medical diseases before injury and Harris score of hip joint in the final follow-up were recorded. Univariate Logistic regression analysis was used to screen out the risk factors of healthy side fracture after operation,and then statistically significant risk factors were included in multi factor Logistic regression analysis to screen out the independent risk factors of healthy side fracture after operation of hip fracture in the elderly.
Results: Among them,42 of the 452 patients had hip fractures on the healthy side with an incidence of 9.3%. The average interval between the two fractures was (2.9±2.1) years. Univariate Logistic regression analysis showed that there were significant differences in age,bone mineral density,medical compliance,short-term postoperative deliriun,pre-injury complicated with medical diseases and Harris score of hip joint in the final follow-up (P<0.05). Multivariate Logistic analysis showed that age(OR=4.227),bone mineral density(OR=4.313),combined with medical diseases (OR=5.616) and low hip Harris score at the final follow-up (OR=3.891) were independent risk factors for healthy side fractures after hip fracture surgery in elderly(P<0.05).
Conclusion: The age,bone mineral density,combined with medical diseases and low Harris score of hip joint in the final follow-up are the main risk factors of healthy side fracture after hip fracture in the elderly. It is necessary to strengthen the treatment of medical diseases,anti osteoporosis and improve hip joint function within 3 years after operation,so as to prevent the occurrence of healthy side hip fracture. |
| KEYWORDS:Aged Hip fractures Refracture Risk factors |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 傅华君,陈敏丽,韩雷,胡云根,毕大卫.老年髋部骨折术后健侧骨折的危险因素分析[J].中国骨伤,2022,35(4):353~356 |
| 英文格式: | FU Hua-jun,CHEN Min-li,HAN Lei,HU Yun-gen,and BI Da-wei.Analysis of risk factors of healthy side fracture after hip fracture surgery in the elderly[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(4):353~356 |
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