股骨近端骨折类型的影响因素分析

目的探讨影响股骨近端骨折类型的相关因素。方法对2016年1月至2018年9月河南省洛阳正骨医院髋部诊疗中心297例股骨近端骨折病人的临床资料进行回顾性分析,根据入院时第一诊断结果将其分为股骨颈骨折组与股骨转子间骨折组,其中股骨颈骨折病人206例(69.4%),股骨转子间骨折91例(30.6%)。先通过单因素分析比较两组的性别、年龄、身高、体重、身体质量指数(body mass index,BMI)、生活习惯(吸烟、酗酒)、合并内科疾病(高血压、糖尿病、冠心病、卒中病史、恶性肿瘤、既往骨折史)、股骨颈骨密度、转子间骨密度、全髋骨密度、颈干角、所受能量等因素,再采用Logistic回归分析确定其影响因素。结果两组间年龄、股骨颈骨密度、转子间骨密度、全髋骨密度、颈干角、所受能量比较,差异均有统计学意义(P均<0.05)。Logistic回归分析发现,年龄OR=1.071,95%CI(1.038,1.106),P<0.001]、全髋骨密度OR=0.004,95%CI(0.000,0.356),P=0.016]、颈干角OR=0.915,95%CI(0.881,0.951),P<0.001]为股骨近端骨折类型的影响因素。结论年龄越大、全髋骨密度越低、颈干角越大的病人,更容易发生股骨颈骨折。

Factors influencing types of proximal femoral fractures

Objective To investigate the related factors affecting the types of proximal femoral fracture.Methods The clinical data of 297 patients with proximal femoral fractures treated at the Hip Treatment Center of Luoyang Orthopaedic Hospital of Henan Province from January 2016 to September 2018 were retrospectively analyzed.According to the initial diagnosis results at the time of admission,the patients were divided into the femoral neck fracture group(206 cases,69.4%) and the intertrochanteric fracture group(91 cases,30.6%).Univariate analysis was used to compare factors such as gender,age,height,weight,body mass index(BMI),lifestyle(smoking,alcohol abuse),and medical conditions(hypertension,diabetes,coronary heart disease,history of stroking,malignancy,previous fracture history),femoral neck bone density,intertrochanteric bone density,total hip bone density,neck shaft angle,and energy received between the two groups.Logistic regression analysis was used to determine the independent influencing factors.Results The data between the two groups showed that age,femoral neck bone mineral density,intertrochanter bone mineral density,total hip bone density,neck shaft angle,and energy received were statistically significant(P<0.05 for all).Logistic regression analysis revealed that ageOR=1.071,95% CI(1.038,1.106),P<0.001],total hip bone densityOR=0.004,95% CI(0.000,0.356),P=0.016],neck shaft angle OR=0.915,95% CI(0.881,0.951),P<0.001]were the independent factors influencing the proximal femoral fractures.Conclusion Patients with older age,lower total hip bone density,and larger femoral neck shaft angle are more likely to have femoral neck fractures.