[1]刘雅克,王洪,朱鸣镝,等.老年髋部骨折术后对侧再骨折的随访研究[J].中华老年骨科与康复电子杂志,2017,(04):205-209.[doi:10.3877/cma.j.issn.2096-0263.2017.04.003]
　Liu Yake,Wang Hong,Zhu Mingdi,et al.The contralateral fractures after the hip fracture in the elderly[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(04):205-209.[doi:10.3877/cma.j.issn.2096-0263.2017.04.003]
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老年髋部骨折术后对侧再骨折的随访研究()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2017年04期
页码:
205-209
栏目:
髋部骨折
出版日期:
2017-07-15

文章信息/Info

Title:
The contralateral fractures after the hip fracture in the elderly
作者:
刘雅克; 王洪; 朱鸣镝; 陆跃; 徐华; 陶然; 周振宇
226001 南通大学附属医院骨科
Author(s):
Liu Yake;  Wang Hong;  Zhu Mingdi;  Lu Yue;  Xu Hua;  Tao Ran;  Zhou Zhenyu
Department of Orthopedics, the Affiliated Hospital of Nantong University, Nantong 226001, China
关键词:
髋骨折;  老年人;  对侧再骨折;  随访
Keywords:
Hip fractures;  Aged;  Re-fractures;  Follow-up
DOI:
10.3877/cma.j.issn.2096-0263.2017.04.003
文献标志码:
A
摘要:
目的 探讨老年髋部骨折术后对侧再骨折的危险因素。方法 回顾性收集南通大学附属医院骨科收治的老年髋部骨折术后患者 407例，记录患者的一般特征、骨质疏松情况、伴发疾病、内固定治疗方式、随访期间功能锻炼情况和治疗依从性等情况，采用 Kaplan-meier曲线描述术后累计对侧髋部再骨折的情况。以单因素 Log-rank时序检验和 Cox比例风险模型分析可能的危险因素。结果 368例患者获得成功随访，随访率 90.4%。随访时间（24±6）个月，其中 21例（5.7%）患者发生对侧髋部再骨折。发生再骨折和未发生再骨折的两组患者在骨质疏松、脑卒中、老年痴呆及白内障等特征上，差异均有统计学意义（c2=4.181，c2=0.678，c2=5.657，c2=4.965，P＜0.05）；而在性别、年龄、吸烟情况、酗酒情况及骨折类型等情况上无统计学差异（P＞0.05）。Log-rank检验和 Cox模型显示：老年髋部骨折患者如果伴发骨质疏松、脑卒中、老年痴呆及白内障，再发对侧髋部骨折的机会将增加（P＜0.05）。结论 老年髋部骨折术后存在一定的对侧再骨折可能，而伴发骨质疏松、脑卒中、老年痴呆及白内障是其独立的危险因素。对于此类患者，术后应给予重点关注，防止再骨折的发生。
Abstract:
Objective To explore the contralateral hip fractures in the elderly and analyze the related risk factors. Methods A total of 407 patients with hip fractures underwent surgical treatments were included in this study. General characteristics of patients, information of osteoporosis, concomitant diseases, internal fixation and functional exercise during follow-up and treatment compliance were recorded for risk factor analysis. Kaplan-meier curve was used to describe the postoperative re-fractures. Using log-rank test and Cox proportional hazards model to analysis potential risk factors. Results A total of 368 patients (90.4%) completed follow-up with an average of 24±6 month. During follow-up, 21 patients (5.7%) had a contralateral hip fracture. There were significant differences in osteoporosis, stroke, senile dementia and cataract (c2=4.181, c2=0.678, c2=5.657, c2=4.965, P<0.05) between two groups who had fractures and nonfractures, while no significant difference on gender, age, smoking, drinking and type of fracture. Log-rank test and Cox model also showed that osteoporosis, stroke, senile dementia and cataract were independent risk factors for re-fracture (P<0.05). Conclusion Postoperative collateral fracture is possible in the elderly hip fractures. Osteoporosis, stroke, senile dementia and cataract are independent risk factors. For such patients, postoperative attention should be given to prevent refracture.

参考文献/References:

1 Omsland TK, Emaus N, Tell GS, et al. Ten- year risk of second hip fracture. A NOREPOS study [J]. Bone, 2013, 52(1): 493-497.
2 Ryg J, Rejnmark L, Overgaard S, et al. Hip fracture patients at risk of second hip fracture:a nationwide population- based cohort study of 169,145 cases duri [J]. J Bone Miner Res, 2009, 24(7): 1299-1307.
3 van der Steenhoven TJ, Staffhorst B, Van de Velde SK, et al. Complications and institutionalization are almost doubled after second hip fracture surgery in the elderly patient [J]. J Orthop Trauma, 2015, 29(3): 103-108.
4 Sobolev B, Sheehan KJ, Kuramoto L, et al. Excess mortality associated with second hip fracture [J]. Osteoporos Int, 2015, 26(7): 1903-1910.
5 Sawalha S, Parker MJ. Characteristics and outcome in patients sustaining a second contralateral fracture of the hip [J]. J Bone Joint Surg Br, 2012, 94(1): 102-106.
6 Bliuc D, Nguyen ND, Milch VE, et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women [J]. JAMA, 2009, 301(5): 513-521.
7 Shen SH, Huang KC, Tsai YH, et al. Risk analysis for second hip fracture in patients after hip fracture surgery: a nationwide populationbased study [J]. J Am Med Dir Assoc, 2014, 15(10): 725-731.
8 Hagino H, Sawaguchi T, Endo N, et al. The risk of a second hip fracture in patients after their first hip fracture [J]. Calcif Tissue Int, 2012, 90(1): 14-21.
9 Egan M, Jaglal S, Byrne K, et al. Factors associated with a second hip fracture: a systematic review [J]. Clin Rehabil, 2008, 22(3): 272-282.
10 Angthong C, Suntharapa T, Harnroongroj T. Major risk factors for the second contralateral hip fracture in the elderly [J]. Acta Orthop Traumatol Turc, 2009, 43(3): 193-198.
11 Simon P, Gouin F, Veillard D, et al. Femoral neck fractures in patients over 50 years old [J]. Rev Chir Orthop Reparatrice Appar Mot, 2008, 94 Suppl(6): 108-S132.
12 Black DM, Delmas PD, Eastell R, et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis [J]. N Engl J Med, 2007, 356(18): 1809-1822.
13 Hung JK, Chang IL, Yu CT. Assessment of protective and risk factors of the second contralateral hip fracture in the elderly [J]. J Clin Densitom, 2010, 15(4): 500-500.
14 AGS Guiding Principles for the Care of Older Adults with Multimorbid? ity [DB/OL]. http://www.americangeriatrics.org/health_care_professionals/clinical_practice/clinical_guidelines_recommendations/pre - vention_of_falls_summary_of_recommendations. 2010
15 Huang KC, Huang TW, Yang TY, et al. Chronic NSAIDs use increases the risk of a second hip fracture in patients after hip fracture surgery: evidence from a STROBE- Compliant Population- Based study [J]. Medicine (Baltimore), 2015, 94(38): 1566.
16 Chuang PY, Shen SH, Yang TY, et al. Non- steroidal antiinflammatory drugs and the risk of a second hip fracture:a propensityscore matching study [J]. BMC Musculoskelet Disord, 2016, 17: 201- 201.

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备注/Memo

备注/Memo:
南通大学自然科学类科研基金前期预研项目（16ZY25）
更新日期/Last Update: 2017-07-14