目的分析2008—2012年成人浮膝损伤患者的临床特点,探讨青年患者与中老年患者性别、合并骨折及骨折类型构成的差异,为此类骨折的诊治、预防等临床研究提供参考。方法回顾性分析河北医科大学第三医院2008年1月—2012年12月间诊治的成人(≥16岁)浮膝损伤患者资料,排除陈旧骨折、病理骨折及假体周围骨折等。所有影像资料由经过培训的4名本院骨科住院医师进行整理分型,并由本院2名骨科主任医师及1名放射科主任医师进行监督检验,统计年龄、性别、骨折类型及合并骨折等数据。≤45岁患者为青年组,>45岁患者为中老年组。结果5年间共诊治成人浮膝损伤204例208侧,占成人全身骨折的0.40%(204/52225),占成人股骨骨折的3.93%(204/5196),占成人胫腓骨骨折2.49%(204/8199)。其中男173例,女31例；年龄16~85岁；青年组153例,中老年组51例。青年患者和中老年患者中均以男性为主,分别占90.20%(138/153)和68.63%(35/51),差异有统计学意义(字2=13.808,P<0.01)。浮膝损伤患者中131例合并其他部位骨折,占浮膝损伤患者的64.22%(131/204),主要为合并足部骨折37例,尺桡骨骨折33例,骨盆-髋臼骨折31例,股骨近端骨折25例,对侧股骨骨折25例等；其中青年组合并其他部位骨折95例,中老年组36例,差异无统计学意义(字2=1.202,P>0.05)。 FraserⅠ型骨折87侧,Ⅱ型骨折121侧,青年组与中老年组患者FraserⅠ型、Ⅱa型、Ⅱb型、Ⅱc型分别是70、40、16、30侧和17、12、5、18侧,两组各型骨折构成比差异并无统计学意义(字2=5.502,P>0.05)；Ⅱ型骨折中Ⅱb型骨折最少(21侧),Ⅱa、Ⅱc型骨折所占比例相近,但青年患者Ⅱa型(46.51%,40/86)骨折多于Ⅱc型(34.88%,30/86)骨折,中老年患者中Ⅱc型(51.43%,18/35)骨折较Ⅱa型(34.29%,12/35)骨折更多。结论青年男性为浮膝损伤的高危人群,常合并其他部位骨折。胫骨平台较股骨髁发生骨折的风险高,且骨折风险均随着年龄的增长而增高。
目的分析2008—2012年成人浮膝損傷患者的臨床特點,探討青年患者與中老年患者性彆、閤併骨摺及骨摺類型構成的差異,為此類骨摺的診治、預防等臨床研究提供參攷。方法迴顧性分析河北醫科大學第三醫院2008年1月—2012年12月間診治的成人(≥16歲)浮膝損傷患者資料,排除陳舊骨摺、病理骨摺及假體週圍骨摺等。所有影像資料由經過培訓的4名本院骨科住院醫師進行整理分型,併由本院2名骨科主任醫師及1名放射科主任醫師進行鑑督檢驗,統計年齡、性彆、骨摺類型及閤併骨摺等數據。≤45歲患者為青年組,>45歲患者為中老年組。結果5年間共診治成人浮膝損傷204例208側,佔成人全身骨摺的0.40%(204/52225),佔成人股骨骨摺的3.93%(204/5196),佔成人脛腓骨骨摺2.49%(204/8199)。其中男173例,女31例；年齡16~85歲；青年組153例,中老年組51例。青年患者和中老年患者中均以男性為主,分彆佔90.20%(138/153)和68.63%(35/51),差異有統計學意義(字2=13.808,P<0.01)。浮膝損傷患者中131例閤併其他部位骨摺,佔浮膝損傷患者的64.22%(131/204),主要為閤併足部骨摺37例,呎橈骨骨摺33例,骨盆-髖臼骨摺31例,股骨近耑骨摺25例,對側股骨骨摺25例等；其中青年組閤併其他部位骨摺95例,中老年組36例,差異無統計學意義(字2=1.202,P>0.05)。 FraserⅠ型骨摺87側,Ⅱ型骨摺121側,青年組與中老年組患者FraserⅠ型、Ⅱa型、Ⅱb型、Ⅱc型分彆是70、40、16、30側和17、12、5、18側,兩組各型骨摺構成比差異併無統計學意義(字2=5.502,P>0.05)；Ⅱ型骨摺中Ⅱb型骨摺最少(21側),Ⅱa、Ⅱc型骨摺所佔比例相近,但青年患者Ⅱa型(46.51%,40/86)骨摺多于Ⅱc型(34.88%,30/86)骨摺,中老年患者中Ⅱc型(51.43%,18/35)骨摺較Ⅱa型(34.29%,12/35)骨摺更多。結論青年男性為浮膝損傷的高危人群,常閤併其他部位骨摺。脛骨平檯較股骨髁髮生骨摺的風險高,且骨摺風險均隨著年齡的增長而增高。
목적분석2008—2012년성인부슬손상환자적림상특점,탐토청년환자여중노년환자성별、합병골절급골절류형구성적차이,위차류골절적진치、예방등림상연구제공삼고。방법회고성분석하북의과대학제삼의원2008년1월—2012년12월간진치적성인(≥16세)부슬손상환자자료,배제진구골절、병리골절급가체주위골절등。소유영상자료유경과배훈적4명본원골과주원의사진행정리분형,병유본원2명골과주임의사급1명방사과주임의사진행감독검험,통계년령、성별、골절류형급합병골절등수거。≤45세환자위청년조,>45세환자위중노년조。결과5년간공진치성인부슬손상204례208측,점성인전신골절적0.40%(204/52225),점성인고골골절적3.93%(204/5196),점성인경비골골절2.49%(204/8199)。기중남173례,녀31례；년령16~85세；청년조153례,중노년조51례。청년환자화중노년환자중균이남성위주,분별점90.20%(138/153)화68.63%(35/51),차이유통계학의의(자2=13.808,P<0.01)。부슬손상환자중131례합병기타부위골절,점부슬손상환자적64.22%(131/204),주요위합병족부골절37례,척뇨골골절33례,골분-관구골절31례,고골근단골절25례,대측고골골절25례등；기중청년조합병기타부위골절95례,중노년조36례,차이무통계학의의(자2=1.202,P>0.05)。 FraserⅠ형골절87측,Ⅱ형골절121측,청년조여중노년조환자FraserⅠ형、Ⅱa형、Ⅱb형、Ⅱc형분별시70、40、16、30측화17、12、5、18측,량조각형골절구성비차이병무통계학의의(자2=5.502,P>0.05)；Ⅱ형골절중Ⅱb형골절최소(21측),Ⅱa、Ⅱc형골절소점비례상근,단청년환자Ⅱa형(46.51%,40/86)골절다우Ⅱc형(34.88%,30/86)골절,중노년환자중Ⅱc형(51.43%,18/35)골절교Ⅱa형(34.29%,12/35)골절경다。결론청년남성위부슬손상적고위인군,상합병기타부위골절。경골평태교고골과발생골절적풍험고,차골절풍험균수착년령적증장이증고。
Objective To analyze the clinical features of adult floating knee injury from 2008 to 2012, explore the differences between young and elderly patients in gender, concomitant fractures and fracture type composition, and provide a base of diagnosis, treatment, prevention and research for floating knee injury. Methods The data of the adult (≥16 years old) floating knee injury admitted to the Third Hospital of Hebei Medical University from January 2008 to December 2012 were retrospectively analyzed. All the fractures were acute and the pathological or periprosthetic fractures were excluded. The radiography of fracture were classified by 4 same experienced orthopedic residents and verified by two orthopedic deans and one radiologist. The gender, age, concomitant fractures and fracture classification were analyzed. The patients aged less than 45 years old were defined as young patients, and the patients older than 45 years old were defined as elderly patients. Results A total of 204 patients of adult patients with 208 floating knee were collected. The floating knees accounted for 0. 40%( 204/52 225 ) of all adult fractures, 3. 93%(204/5 196) of adult femoral fractures and 2. 49%(204/8 199) of adult tibia and fibula fractures. Among them, there were 173 males and 31 females. The ages of all the patients were between 16 and 85 years old, 153 of them were young patients and 51 patients were elderly patients. The male patients accounted for 90. 20% ( 138/153 ) and 68. 63% ( 35/51 ) in young patients and elderly patients, respectively, the difference had statistical sense(字2 =13. 808, P <0. 01). One hundred and thirty-one patients which accounted for 64. 22% of 204 patients of the floating knee injury accompanied by other fractures, mainly included 37 patients accompanied by foot fracture, 33 patients accompanied by radius and ulna fracture, 31 patients accompanied by pelvis-acetabular fractures, 25 patients accompanied by proximal femoral fractures, 25 patients accompanied by contralateral femoral fractures. These 131 sides contain 95 patients of young patients and 36 patients of elderly patients. There was no significant difference in the proportion of patients combined with other part fractures between young patients and elderly patients (字2 =1. 202, P>0. 05). According to Fraser’s classification criteria, there were 87 sides of typeⅠfracture and 121 sides of typeIIfracture. The number of knee of young patient who belonged to type Ⅰ, type IIa, type IIb and type IIc were 70, 40, 16, 30, respectively. The number of knee of elderly patient who belonged to type Ⅰ, typeIIa, typeIIb and typeIIc were 17, 12, 5, 18, respectively. The composition ratio of various fracture had no significant difference between young patients and elderly patients( 字2 =5. 502, P>0. 05). In type IIfractures, fractures of type IIb were at least ( 21 ) , fractures of type IIa and type IIc had a similar proportion. Fractures of type IIa (46. 51%, 40/86) were more common than type IIc fracture(34. 88%, 30/86) in young patients, but type IIc (51. 43%, 18/35) fractures were more common than type IIa (34. 29%, 12/35)in elderly patients. Conclusions Young men are the at-risk population of floating knee injury and usually combied with other fractures. Compared to the femoral condyle, tibial plateau has a higher fracture risk, and the risk will increase with age.
