老年髋部骨折术后对侧髋部再骨折的危险因素分析

发布时间：2018-05-15 14:00

本文选题：髋骨折 + 再骨折　；参考：《中国骨伤》2016年04期

【摘要】：目的 :探讨老年髋部发生二次骨折的相关风险因素,为预防对侧髋部再骨折提供临床依据。方法 :回顾性分析2008年12月至2014年2月378例老年髋部初次骨折患者的资料,男175例,女203例;年龄60~90岁,平均(75.53±8.04)岁;股骨颈骨折125例,股骨粗隆间骨折253例。术后随访12~36个月,平均24.9个月,32例患者发生对侧髋部再骨折,男13例,女19例;年龄72~95岁,平均(81.25±5.94)岁;股骨颈骨折7例,股骨粗隆间骨折25例。根据患者术后有无对侧髋部再骨折分为骨折组和无骨折组,比较两组患者的年龄、性别、初次骨折类型、内固定方式、卧床时间、骨质疏松情况、合并内科疾病情况、术后功能锻炼、治疗的依从性、生活环境(农村/城市)和末次随访时Harris评分,对于P0.05的因素进行多因素Logistic回归性分析。结果:骨折组与无骨折组的年龄、骨质疏松情况、合并内科疾病情况、术后功能锻炼、医疗依从性及末次随访时Harris评分比较差异均有统计学意义(P0.05)。多因素Logistic分析结果显示:骨质疏松(OR=6.793,P=0.001),高龄(OR=4.170,P=0.002),合并内科疾病(OR=3.828,P=0.005),术后功能锻炼(OR=0.297,P=0.005)以及医疗依从性(OR=0.295,P=0.007)是老年髋部骨折术后对侧髋部再骨折的主要危险因素。结论:老年髋部骨折术后对侧再骨折主要危险因素是高龄、骨质疏松、合并内科疾病、术后功能锻炼和医疗依从性。术后需加强抗骨质疏松治疗、积极治疗内科疾病,坚持功能锻炼,以预防髋部再次骨折的发生。
[Abstract]:Objective: to investigate the risk factors of secondary hip fracture in elderly patients and to provide clinical evidence for prevention of contralateral hip refracture. Methods: the data of 378 elderly patients with primary hip fracture from December 2008 to February 2014 were retrospectively analyzed, including 175 males and 203 females, aged 60 to 90 years (mean 75.53 卤8.04), femoral neck fracture in 125 cases and intertrochanteric fracture in 253 cases. Postoperative follow-up ranged from 12 to 36 months (mean 24.9 months) in 32 patients with refracture of the contralateral hip, including 13 males and 19 females, aged from 72 to 95 years (mean 81.25 卤5.94) years, femoral neck fracture in 7 cases and intertrochanteric fracture in 25 cases. According to whether the patients had a contralateral hip refracture after operation, they were divided into two groups: fracture group and non-fracture group. The age, sex, type of primary fracture, internal fixation, bed rest time, osteoporosis, and internal medical diseases were compared between the two groups. Postoperative functional exercise, therapeutic compliance, living environment (rural / urban) and Harris score at the last follow-up were analyzed by multivariate Logistic regression analysis. Results: there were significant differences in age, osteoporosis, internal diseases, postoperative functional exercise, medical compliance and Harris score between the fracture group and the non-fracture group (P 0.05). The results of multivariate Logistic analysis showed that the main risk factors for the contralateral hip refracture in the elderly patients were: Osteoporosis (Osteoporosis) 6.793 (P0. 001), aged OR4. 170 (P0. 002), combined with internal diseases (OR3. 828) P0. 005, postoperative functional exercise (0. 297P0. 005) and medical compliance (OR0. 295P0. 007). Conclusion: the main risk factors of contralateral refracture after hip fracture in elderly patients are old age, osteoporosis, internal diseases, postoperative functional exercise and medical compliance. After operation, anti-osteoporosis treatment should be strengthened, internal diseases should be actively treated, and functional exercise should be carried out to prevent the occurrence of hip refracture.
【作者单位】：宁波市北仑区人民医院;
【分类号】：R687.3

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