河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (1): 30-33.doi: 10.3969/j.issn.1007-3205.2021.01.007

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老年髋部骨折术后对侧髋部再骨折的发生率及危险因素分析

  

  1. 1.河北省人民医院骨科,河北石 家庄 050051;2.北京积水潭医院创伤骨科,北京 100035
  • 出版日期:2021-01-25 发布日期:2021-02-05
  • 作者简介:杨朝旭(1981-),男,河北邢台人,河北省人民医院主治医师,医学硕士,从事创伤骨科疾病诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题计划(20150120)

Incidence and risk factors of contralateral hip refracture after hip fracture surgery in the elderly patients

  1. 1.Department of Orthopedics, Hebei General Hospital, Shijiazhuang 050051, China; 
    2.Department of Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China
  • Online:2021-01-25 Published:2021-02-05

摘要: 目的  调查老年髋部骨折术后对侧髋部再骨折的发生率及危险因素。
方法  回顾性分析在积水潭医院创伤骨科住院手术治疗的老年髋部骨折患者356例,依据术后1年内对侧髋部有无再发骨折分为再骨折组32例和无再骨折组324例,比较年龄、体重指数、是否规律日照、合并内科疾病、骨质疏松情况、发生第一次髋部骨折后对抗骨质疏松药物依从性、运动锻炼情况等指标;用多因素Logistic分析模型确定对侧髋部骨折的危险因素。
结果  356例髋部患者中32例发生对侧髋部再骨折,再骨折发生率为9.0%。多因素Logistic回归分析,高龄、重度骨质疏松、缺乏规律日照、合并多种内科疾病、发生第一次髋部骨折后对抗骨质疏松药物依从性差、缺乏适当运动锻炼是老年髋部骨折术后对侧髋部再发骨折的危险因素(P<0.05)。
结论  老年髋部骨折术后对侧髋部再发骨折的发生率为9.0%,积极控制体重、规律日照、防治基础疾病,规律行抗骨质疏松治疗,加强宣教,提高患者对抗骨质疏松药物依从性,进行适当运动锻炼可降低髋部再骨折的发生率。


关键词: 髋骨折, 危险因素, 骨质疏松, 再骨折

Abstract: Objective  To investigate the incidence and risk factors of contralateral hip refracture after hip fracture surgery in the elderly patients. 
Methods  Clinial data of 356 patients who underwent surgery retrospectively analyzed. The patients were divided into refracture group(n=32) and non-refracture group(n=324) according to the recurrence of contralateral hip fracture within 1 year after initial hip fracture surgery. The age, body mass index(BMI), regular sun exposure, combined medical diseases, osteoporosis, compliance of anti-osteoporosis drugs after initial hip fracture, frequency of exercise and other variables were recorded and compared between two groups. All variables were entered into a multivariate logistic analysis model to determine the risk factors of contralateral hip refracture. 
Results  Thirty-two of the 356 hip patients suffered from contralateral hip refracture, with a re-fracture incidence of 9.0%. Multivariate Logistic regression analysis showed that advanced age, serious osteoporosis, lack of regularsunexposure, combined with a variety of medical diseases, poor compliance of anti-osteoporosis drugs after the initial hip fracture, and lack of appropriate exercise were risk factors for contralateral hip refracture after hip fracture surgery in the elderly patients(P<0.05). 
Conclusion  The incidence of contralateral hip refracture after initial hip fracture surgery in the elderly was 9.0%. An active management of body weight, regular sun exposure, prevention and treatment of combined medical diseases, regularly intake of anti-osteoporosis drugs, strengthening education, boosting the compliance of anti-osteoporosis, and appropriate exercise can reduce the incidence of hip refracture.


Key words: hip fractures, risk factors, osteoporosis, refracture