A Retrospective Study On The Influencing Factors Of Osteoporotic Fractures And Secondary Fractures

Objective:To analyze the difference between the second fracture and the first fracture by collecting statistics on the gender,age,primary fracture and secondary fracture of patients who were diagnosed with osteoporotic fractures in the Department of Orthopedics and Traumatology,Yangzhou Hospital of Traditional Chinese Medicine in the past 3 years.To guide the clinical treatment of patients with osteoporotic fractures and prevent the occurrence of secondary fractures.Methods:Statistics of patients diagnosed with osteoporosis and fractures in Yangzhou Hospital of Traditional Chinese Medicine were collected,and their names,gender,age,bone mineral density,fracture site,medical history of underlying diseases,syndrome types,and whether there was a second time were collected.Fracture history,antiosteoporosis treatment.For patients with a history of secondary fractures,the location of secondary fractures,treatment methods,and lifestyle changes after primary fractures were collected,and a retrospective study was conducted based on the data.SPSS24.0 statistical software was used for data analysis to analyze the influencing factors between primary fracture and secondary fracture of osteoporosis.result:1.In this study,there were 67 male patients and 233 female patients,with a maleto-female ratio of 1:3.5.Female patients with osteoporotic fractures were much larger than males.The average age of the patients was（74.3±9.2）years old,and the age ranged from 50 to 96 years old.Among them,70 to 90 years old had the largest population,accounting for 65.7%of the total population.In the distribution of fracture sites,there were 162 patients with vertebral osteoporotic fractures,with an average age of（73.5±8.6）years;83 patients with hip fractures,with an average age of（79.9±6.8）years,and 32 patients with proximal humerus fractures,with an average age of（79.9±6.8）years.The age was（71.6±9.4）years old,and 23 patients had distal radius fracture,with an average age of（64.0±8.5）years old.The most patients were thoracolumbar vertebral fractures,accounting for 54%in total,hip fractures accounted for 27.7%,proximal humerus fractures accounted for 10.7%,and distal radius fractures accounted for 7.6%.2.In terms of fracture treatment,a total of 52 people in this study chose conservative treatment,and 248 people chose surgical treatment.Among the patients undergoing vertebral fracture surgery,76 patients chose PVP surgery,and 46 patients chose PKP surgery.Among the 83 patients with hip fractures,all underwent surgical treatment,including 50 patients with femoral trochanteric fractures and 33 patients with femoral neck fractures.Artificial femoral head replacement,including 12 total hip replacement patients and 21 artificial femoral head replacement patients.Twenty-three of the proximal humerus fractures were treated with surgery,and the choice of surgery was plate internal fixation.Twenty patients with distal radius fractures were treated with surgery,and the choice of surgery was plate internal fixation.3.Among the 300 cases of TCM syndrome types collected this time,38 patients with qi stagnation and blood stasis,with an average age of（60.5±6.0）years;90 cases of qi deficiency and blood stasis,with an average age of（74.±6.3）years 88 cases with spleen and kidney yang deficiency,with an average age of（81.4±7.3）years;84 cases of liver and kidney yin deficiency,with an average age of（73.1±7.0）years.Patients with qi stagnation and blood stasis are mostly concentrated in the age of 60,patients with qi deficiency and blood stasis and liver and kidney yin deficiency are mostly concentrated in 70 years old,and patients with spleen and kidney yang deficiency are mostly concentrated in 80 years old and above.4.Among the patients with secondary fractures,there are as many as 60 female patients and only 11 male patients.The male to female ratio is about 1:5.5.The mean age of patients with secondary fractures was（78.4±8.9）years old.Among them,age was statistically significant,and age above 70 years was an influencing factor for secondary fractures,but gender was not statistically significant.5.At the site of secondary fractures,43 patients had vertebral fractures,20 had hip fractures,6 had proximal humerus fractures,and 2 had distal radius fractures.In the secondary fracture of vertebral body,T10 vertebral body had statistical significance（P=0.02,P<0.05）,and other vertebral bodies had no effect on secondary fracture.However,in the study,T12,L1,L2,and trochanteric secondary fractures had a higher incidence.6.In the choice of treatment methods,conservative treatment and surgical treatment were statistically significant（P=0.02,P<0.05）,and the incidence of secondary fractures in patients treated with surgery after one fracture was lower than that in conservative treatment.However,the choice of surgical method was not statistically significant for secondary fractures.7.In this study,anti-osteoporosis treatment is an important factor affecting the secondary fracture,and the presence or absence of anti-osteoporosis treatment has statistical significance for the secondary fracture（P=0.031,P<0.05）.8.In the distribution of TCM syndrome types of secondary fractures,patients with liver and kidney yin deficiency（P=0.037,P<0.05）and patients with spleen and kidney yang deficiency（P=0.002,P<0.05）have statistical significance for secondary fractures.9.When analyzing the underlying diseases of the patients with secondary fractures,there was a statistically significant difference between patients with brain diseases and secondary fractures（P=0.009,P<0.05）.10.There is a statistically significant difference between the two fractures after TCM exercises after one fracture（P=0.017,P<0.05）.