沈阳男性髋部骨折多于女性原因探讨

为找出沈阳地区髋部骨折发生男性多于女性的原因，探索该病在不发达国家或地区的流行特点，我们再次通过查阅病例记录，对沈阳市１９９４年５０岁以上人口的部分髋部骨折病发生的原因进行了较详细的调查分析。共调查分析２６６髋部骨折病例，其中男１６３例，女１０３例。损伤原因记为单纯摔倒（滑倒或绊倒）、骑自行车摔倒、自行车撞倒、机动车事故和高位跌下（滚楼梯或从较高位置掉下）。结果表明：男女在髋部骨折伤因构成上有差别（Ｐ＝０．００４）。女性髋部骨折的大多数（７０％）是由单纯摔倒引起，而在男性则不足一半（４９％），即男性髋部骨折的一半以上不是由于单纯摔倒而是由各种意外事故造成的（Ｐ＝０．０００８）。在各种意外事故中，男性骑自行车摔倒引起骨折的频率（２８％）明显高于女性（１０％）。除了骑自行车摔倒外，男性由自行车撞倒和高位跌下引起骨折的频率稍高于女性，但无太大差别。机动车事故造成骨折的频率男女基本一致。此结果在一定的程度上说明，１９９４年沈阳５０岁以上的男性髋部骨折发病率高是由于男性发生的各种意外事故多，尤其是骑自行车引起的事故造成的。

Causes of higher frequency of hip fracture in males than in females in Shenyang

The objective of this study was to investigate why hip fracture frequency was higher in males than in females in Shenyang in 1994 and the epidemiological feature of hip fracture in such an undeveloped area,using part of medical records (59% ) of hip fracture in the population over 50 years of age in Shenyang collected from Shenyang Orthopaedic Hospital. A total of 266 medical records of hip fractures (163 males and 103 females) were investigated. The causes of hip fracture were recorded as simple fall,falling down from bicycle,bicycle accident, car accident and falling down from a high altitude. There were differences in the causes of hip fracture between males and females (P= 0. 004). Most of hip fractures in females were caused by simple fall (70% )whilst the same cause only contributed 49 %of hip fractures in males (P = 0. 0008), i. e., more than 50% of hip fractures in males were caused by various accidents. Among these accidents,the frequency of hip fractures caused by falling down from bicycle was much higher in males (28% )than in females (10% ). In addition, the frequencies of hip fractures caused by bicycle accident and falling down from a high altitude were slightly higher in males than in females. The frequencies of hip fractures caused by car accident in males and females were the same.The results demonstrated that the higher hip fracture frequecy in males in 1994 was attributed to more accidents,especially from bicycle-related accidents, ouurred in males than in females.