老年髋部骨折后对侧再骨折相关风险

摘要

目的探讨老年髋部骨折后再发对侧髋部骨折的临床特征，以提高对再发对侧髋部骨折相关风险的认识。方法回顾性分析2007年1月至2016年7月收治的老年髋部骨折患者185例，其中35例再发对侧髋部骨折患者为观察组，其余150例为对照组。比较两组患者的性别、年龄、骨折类型、骨皮质指数及内科并发症，分析对侧髋部再骨折的发生率及再骨折时间间隔。结果观察组与对照组性别、年龄、骨折类型比较，差异无统计学意义（P＞0.05）。对侧髋部再骨折的发生率为5.2％；再骨折时间间隔为（2.91±2.16）年；观察组骨皮质指数低于对照组，差异有统计学意义（ P＜0.05）。并发高血压和心脏疾病患病率比较，观察组高于对照组，差异有统计学意义（ P＜0.05）。结论骨皮质指数下降及内科并发症增多是老年髋部再骨折的不利因素，初次骨折后应积极进行抗骨质疏松和内科并发症治疗，同时强调骨折后3年内的防护，以预防对侧髋部再骨折发生。%Objective To analyze risk factors of contralateral hip fracture in elderly patients with hip fracture , in order to improve the understanding of contralateral hip re-fracture.Methods From January 2007 to July 2016, a ret-rospective study was conducted in 185 elderly patients with hip fractures , including 35 patients who had re-fracture at the contralateral hip as the observation group and the other 150 patients as the control group .The gender , age, fracture type, re-fracture interval, bone cortical index, and complications were analyzed.Results The gender, age, and fracture type in both groups were similar ( P>0.05 ) .The incidence of contralateral hip fracture was 5.2%.The average re-frac-ture interval was (2.91 ±2.16) years.The bone cortical index of the observation group were less than the control and the difference had statistical significance ( P<0.05 ) .Hypertention and cardiac disease incidence were statistically high in the observation group ( P<0.05 ) .Conclusions The decrease of bone cortical index and a higher rate of complications may be risk factors for contralateral hip fracture in elderly patients .Active treatments of osteoporosis and complications should be recommended .The protection in 3 years after hip fracture is of great importance in order to prevent the occur-rence of contralateral hip fracture .