河北医科大学第三医院956例后踝骨折的流行病学分析

目的探讨后踝骨折特点及其变化，为治疗后踝骨折制订更合理的方案。 方法回顾性分析2009年1月至2014年12月河北医科大学第三医院收治的后踝骨折患者的临床资料，分析患者性别、年龄、骨折部位分布等特点。 结果共收集踝关节骨折4 278例，956例发生后踝骨折，其中男性555例（58.05%），女性401例（41.95%），男女比为1.38∶1。骨折高发年龄为20~60岁；≤50岁的患者中，男性明显多于女性；>50岁的患者中，女性明显多于男性；各年龄段性别构成比差异有统计学意义（P<0.05）。前三年骨折高发部位为后踝骨折合并外踝骨折（37.7%），其次为后踝合并内踝骨折（10.2%）和三踝骨折（1.9%%），后三年骨折高发部位为三踝骨折（26.1%），其次为后踝合并内踝骨折（7.0%）和后踝合并外踝骨折（4.5%）；两时间段骨折部位构成比差异有统计学意义（P<0.001）。致伤原因的前三位分别为扭伤（35.4%）、交通伤（28.1%）和摔伤（23.0%）。 结论后踝关节骨折高发年龄段为20~60岁，男性多于女性；骨折高发部位为后踝骨折合并外踝骨折，后三年三踝骨折人数明显增加，致伤原因以扭伤、交通事故和摔伤为主。

The retrospective analysis of 956 cases with posterior malleolar fractures

ObjectiveTo investigate the characteristics and changes of posterior malleolar fractures, and to develop a more reasonable plan for the treatment of posterior malleolar fractures. MethodsThe retrospective case series was used to analyze the clinical data of patients with posterior malleolar fractures from January 2009 to December 2014, and to analyze the gender, age and distribution of fracture sites. ResultsA total of 4 278 cases of ankle fractures were collected, including 956 posterior malleolar fractures, 555 males and 401 females, with a male to female ratio of 1.38∶1. The high incidence of fractures was 20-60 years old; The adult malleolar injury predominated in an age range of 20 and 60 years. There were more males than females in the group of patients who were less than 50 years and more females than males significantly in the group of patients who were aged over 50 years. The differences of gender constituent ratio at different age were statistical significance (P<0.05). The fractures occurred more commonly on posterior combined with lateral malleolar fracture (37.7%). The posterior malleolar fracture of medial malleolus were 10.2% and three ankle fractures were 1.9% over the first three years. The type often involved of fractures was three ankle fractures (26.1%) three years after. The posterior malleolar fracture of medial malleolus were 7.0% and posterior combined with lateral malleolar fracture were 4.5%. The differences of fracture sites constituent ratio between the two groups were statistical significance (P<0.05). The top three injury mechanism were sprain (35.4%), traffic injury (28.1%) and falls (23%). ConclusionsThe peak age of patients with posterior malleolar fractures were20 to 60 years. Males more than females. The high-risk fracture is posterior malleolar fracture with an external malleolus fracture. The number of fractures in the lastest three years is significantly increased. Common injury mechanism are sprain, traffic accident and falls. The road traffic safety awareness should be strengthened to reduce the incidence of posterior malleolar fracture. Fully understanding of the injury cause at consultation to prevent missed diagnosis, and followed a reasonable treatment plan according to the stability of the ankle joint.