| Background: Many orthopedists of traumatic orthopedics study hip fracture, the morbidity of hip fracture difference between different areas(89-1287/100 0000/year). Intertrochanteric fracture refers to the fracture between the basement of femoral neck to lesser trochanteric, is an important part of hip fracture. Majority patients with intertrochanteric fracture are old people with osteoporosis. When the elderly fall down, the lower limbs excessive outreach or adduction touchdown, or fell down side, bigger trochanteric directly hit the ground will occur intertrochanteric fracture. Recent years, with the rapid aging of the population, intertrochanteric fracture is gradually become a threat to people’s public health problem in our country. Studies have found that patients with intertrochanteric fracture have a higher age, worse general and worse prognosis condition than the patients with femoral neck fracture. Study the clinical characteristics of intertrochanteric fractures and set up a reasonable prevention measures is very important. However, the literatures which research the clinical characteristics of intertrochanteric fractures are very less. Intertrochanteric fractures accounted for 45.26% of the proximal femur fractures and 3.13% of all the fractures. To analyze the gender, age, fracture classification and variation trend of adult intertrochanteric fractures admitted to the Third Hospital of Hebei Province between January 2003 and December 2012, and provide a basis for the treatment and preventive of intertrochanteric fractures.Methods: Retrospectively collected the adult intertrochanteric fracture admitted to the Third Hospital of Hebei Medical University from January 2003 to December 2012 by artificial lookup radiology images repository. All the fractures were acute and the pathological or periprosthetic fracture were excluded. The radiography of fracture were classified by same experienced orthopedic resident and verified by two orthopedic deans and one radiologist. All the intertrochanteric fractures were classification by AO fracture classification standard and Evans classification standard, respectively. All the patients were divided into young patients(16-59 year-old) and elder patients(≥60 year-old) by age, divided into A1, A2, A3 by AO fracture classification standard, and divided into stable(Evans Ⅰ, Ⅱ) and unstable(Evans Ⅲ, Ⅳ, Ⅴ) fracture by Evans classification standard. The gender, age and fracture classification were analyzed and compared between 2003 to 2007 and 2008 to 2012. Statistics analysis were made by SPSS 19.0.Results: A total of 3201 cases were collected. The adult intertrochanteric fractures accounted for 2.97% of all adult fractures and 43.76% of adult proximal femoral fractures. Of all fractures 64.98% were elderly and 35.02% were middle-aged. In elderly, female were common(57.78%) while in middle-aged were male commonly(79.13). According to Evans classification, instable fractures were more common(68.92%). According to AO classification, the most common type was A2(49.7%) and the least was A3(15.9%). Comparing the date between the first 5years and the second 5 years, the proportion of intertrochanteric fracture of adult fracture was decreased 0.31%(?2=9.29, P=0.002) and the proportion of intertrochanteric fracture of adult proximal femoral fractures was decreased 3.15%(?2=7.35, P=0.007). The proportion of elderly patients, female and stable fractures was increased 4.04%(?2=8.16, P=0.004), 5.62%(?2=11.7, P=0.001) and 5.62%(?2=11.7, P=0.001) respectively. The proportion of AO classification was not significantly verified(?2=3.24, P=0.198).Conclusion: By retrospectively analysis the patients admitted to our hospital from January 2003 to December 2012, the preliminary understanding of clinical features of intertrochanteric fracture was made. Most patients with intertrochanteric fracture were old people. According to the AO fracture classification standard, Fractures of type A2 are most. According to Evans fracture classification standard, unstable fractures(Evans III, IV, V) more than stable fractures(Evans I, II). Compare to the patients of the first 5 years, the proportion of female, elderly and stable(Evans I, II) fracture was increased in the second 5 years. According to the AO fracture classification standard, there are no obvious change in the proportion of various fractures in the past 10 years. |
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