本文選題：脛骨平臺骨折　切入點：成人　出處：《河北醫(yī)科大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的:脛骨平臺骨折屬脛骨近端的關節(jié)內骨折,是下肢常見骨折之一,多由高能量損傷引起,可伴有不同程度的關節(jié)面壓縮與移位,將影響膝關節(jié)的對合、穩(wěn)定性與運動。目前國內對于成人脛骨平臺骨折發(fā)病特點和趨勢的研究較少,因此我們調查我院2003~2012年10年間成人脛骨平臺骨折病歷資料,并對前后5年資料進行對比,旨在更加全面地了解成人脛骨平臺骨折的流行病學特征,并分析其發(fā)展趨勢。方法:利用醫(yī)學影像計算機存檔與傳輸系統(tǒng)(PACS)及病案查詢系統(tǒng)調閱河北醫(yī)科大學第三醫(yī)院2003年1月至2012年12月診治的全部成人骨折資料。納入標準:新鮮骨折、年齡≥16周歲。排除標準:顱骨、下頜骨、肋骨、胸骨骨折,病理性骨折,假體周圍骨折,陳舊骨折。將篩選出的全部骨折X線片按AO骨折分類原則進行分型。將所有患者按年齡段進行分組:16~20歲為1組,21~80歲每10歲為1組,81歲以上為1組,并統(tǒng)計各組骨折例數(shù)、構成比并進行對比。將成人脛骨平臺骨折按Schatzker分型原則分為Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ型,并按AO分型原則分為41-B、41-C型。2003年1月至2007年12月收治的患者資料定為A組,2008年1月至2012年12月診治的患者資料定為B組,并進行兩組對比。本研究中計數(shù)資料采用例數(shù)和百分比表示。應用SPSS 19.0統(tǒng)計學軟件進行數(shù)據(jù)分析。兩組患者性別、年齡及骨折類型的構成比等計數(shù)資料的比較采用?2檢驗,P0.05為差異有統(tǒng)計學意義。結果:2003年1月至2012年12月10年間河北醫(yī)科大學第三醫(yī)院共收治成人骨折107648例,其中成人脛腓骨骨折18432例,成人脛骨近端骨折3655例,成人脛骨平臺骨折2004例。成人脛骨平臺骨折占成人全身骨折的1.86%,占成人脛腓骨骨折的10.87%,占成人脛骨近端骨折的54.83%。男性1425例(71.11%),女性579例(28.89%),男女比例為2.5:1。41-50歲年齡段患者所占比例最高(25.65%)。AO分型骨折高發(fā)類型為41-B型(67.91%),Schatzker分型骨折高發(fā)類型為Ⅵ型(22.31%)。A組病例1033例,占成人全身骨折的1.86%(1033/55423),占成人脛腓骨骨折的10.09%(1033/10234),占成人脛骨近端骨折的54.11%(1033/1909)。其中男752例,女281例,50歲以上患者250例(24.20%)。B組病例971例,占成人全身骨折的1.86%(971/52225),占成人脛腓骨骨折的11.84%(971/8198),占成人脛骨近端骨折的55.61%(971/1746)。其中男673例,女298例,50歲以上患者310例(31.93%)。前后5年成人脛骨平臺骨折占同期成人脛腓骨骨折的比例由10.09%上升至11.84%,有統(tǒng)計學差異(P0.001)。性別構成比無明顯變化(P=0.085)。年齡構成發(fā)生變化:50歲以上患者的構成比由24.20%增加至31.93%,,有統(tǒng)計學差異(P0.001)。與A組比較,B組AO 41-B型骨折由64.96%增加至71.06%,C型骨折由35.04%減少至28.94%,差異有統(tǒng)計學意義(P=0.003)。SchatzkerⅡ、Ⅲ、Ⅳ、Ⅴ型構成比變化均有統(tǒng)計學意義(P0.001,P0.001,P=0.007,P0.001)。結論:本研究提示了2003年至2012年10年間成人脛骨平臺骨折的流行病學特征及變化趨勢,成人脛骨平臺骨折占成人全身骨折的1.86%,占成人脛腓骨骨折的10.87%,占成人脛骨近端骨折的54.83%。男性多見,高發(fā)年齡段為41-50歲。AO分型41-B型骨折多見,Schatzker分型Ⅵ型骨折多見。與前5年比較,后5年成人脛骨平臺骨折占同期成人脛腓骨骨折的比例、50歲以上患者構成比、AO 41-B型骨折構成比及SchatzkerⅢ型骨折構成比均增加。
[Abstract]:Objective: proximal tibial fractures of the tibial plateau belong to intra-articular fractures, is one of the more common lower extremity fractures, caused by high energy trauma may be associated with different degree of compression and displacement of the articular surface, the effect of knee joint on stability and movement. At present, the domestic research of the incidence and trend of adult tibial plateau fracture less therefore, we investigated the clinical data in our hospital 2003~2012 10 years adult tibial plateau fracture, and to compare the data before and after 5 years, in order to understand more comprehensive epidemiological characteristics of adult tibial plateau fracture, and analyzes its development trend. Methods: using medical image archiving and communication system (PACS) and access to all medical record query system the Third Hospital of Hebei Medical University from January 2003 to December 2012 adult treatment of fracture data. Inclusion criteria: fresh fractures, aged 16 years of age. Exclusion criteria: under the skull. The jaw, ribs, sternum, pathological fracture, old fracture fracture around the prosthesis, will be screened. All fractures were classified according to X-ray AO fracture classification principle. All the patients were grouped according to age: 16~20 year old for the 1 group, 21~80 years every 10 years into 1 groups over the age of 81 to 1 group, and calculated the number of fractures, the constituent ratio and compared. According to Schatzker classification principles were divided into adult tibial plateau fracture II, III, IV, V, VI, and according to the AO classification principle is divided into 41-B, 41-C type.2003 patient data from January to December 2007 were designated as A group of patients from January 2008 to December 2012 the clinical data set for the B group, and two groups were compared. The count data in this study indicated by the number of cases and percentage. Using SPSS 19 statistical software for data analysis. Two groups of patients with gender, age and fracture type and percentage of count data were compared by the 2 test? P0.05 test, the difference was statistically significant. Results: 107648 cases of fracture were treated from January 2003 to December 2012 10 adults in the Third Hospital of Hebei Medical University, including 18432 cases of adult tibial and fibular fractures, adult proximal tibial fractures in 3655 cases, 2004 cases of adult tibial plateau fracture. Adult tibial plateau fractures accounted for 1.86% of all adult fractures of tibia and fibula, accounting for adults fracture of the 10.87%, 1425 cases of 54.83%. male adult proximal tibial fractures (71.11%), 579 cases were female (28.89%), the proportion of men and women 2.5:1.41-50 years old age group the highest proportion (25.65%) of.AO type fractures in type 41-B type Schatzker type (67.91%), the most frequent fracture type (type VI 22.31%).A group of 1033 cases, accounting for 1.86% of all adult fractures (1033/55423), accounting for 10.09% of adult tibial and fibular fractures (1033/10234), accounting for 54.11% of the adult proximal tibial fractures (1033/1909). There were 752 male and 28 female In 1 cases, 250 cases of patients over 50 years old (24.20%).B group of 971 cases, accounting for 1.86% of all adult fractures (971/52225), accounting for 11.84% of adult tibial and fibular fractures (971/8198), accounting for 55.61% of the adult proximal tibial fractures (971/1746). There were 673 male and 298 female patients, 310 cases of 50 years old more patients (31.93%). After 5 years of adult tibial plateau fracture of tibia and fibula fractures accounted for the same period the proportion of adults increased from 10.09% to 11.84%, there was significant difference (P0.001). No significant changes in sex ratio (P=0.085). The age structure changes: 50 years old patients with constituent ratio increased from 24.20% to 31.93%. There were significant differences (P0.001). Compared with A group, B group and AO type 41-B fractures increased from 64.96% to 71.06%, type C fracture was reduced from 35.04% to 28.94%, the difference was statistically significant (P=0.003).Schatzker II, III, IV, constituent ratio changes were statistically significant (P0.001, P0.001, V P=0.007, P0.001) conclusion: this. This study suggests that the epidemiological characteristics and trends from 2003 to 2012 10 years of adult tibial plateau fractures, adult tibial plateau fractures accounted for 1.86% of all adult fractures, accounting for 10.87% of adult tibial and fibular fractures, proximal tibial fractures accounted for adult 54.83%. male, the age is 41-50 years old.AO type 41-B fractures. Schatzker, type VI fractures were more common. Compared with the previous 5 years, after 5 years of adult tibial plateau fractures accounted for the proportion of adult tibial and fibular fractures, proportion of patients over 50 years old, AO type 41-B fracture and fracture of Schatzker type were increased.

【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3

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相關期刊論文 前1條

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本文編號：1569375