| Objective1.Through clinical retrospective study and analysis of all ages over 50 sacrococcyx fracture were injured when the external force energy level difference,Angle of osteoporosis fracture and external force influence sacrococcyx fractures,based on the theory of "kidney advocate bone" in TCM,kidney Yang deficiency syndrome and elderly patients with sacrococcyx fracture relation close degree,provide sacrococcyx fracture mechanism and the prevention and treatment of new ideas.2.The three-dimensional finite element model was established to verify the impact of osteoporosis on the occurrence of sacrococcyx fractures in the elderly pelvis when falling down,and the corresponding prevention and treatment plan was proposed for the prevention and treatment of sacrococcyx fractures.Methods1.Clinical research:collect on January 1,2013 to December 31,2017,in the first affiliated hospital of guangzhou university of TCM hospital,involving patients with fresh sacrococcyx fractures(age 50 or higher),according to the age in every 10 years as a set of grouped,and through the statistical analysis software SPSSAU online,at the rear of each sacral fractures were injured when the external force is high or low proportion of statistical energy analysis(fell from high,injured by crash,car accident as high-energy injury,trip or no significant injury as low-energy damage),trauma type ratio analysis of each age changes.According to the diagnostic criteria of kidney-yang deficiency,diagnosis and screening were conducted for the patients with sacrococcyx fracture included in the statistics,and the distribution characteristics of each age group were analyzed.The external force Angle of subsequent simulation experiment was determined according to fracture classification.2.Experimental study:one healthy young male volunteer and one elderly male patient with osteoporosis were recruited,and the CT image data of their pelvis were collected.The corresponding 3d model of the pelvic bone was established through Mimics 19.0 and SolidWorks 2014,and the assignments of materials were set in the Hypermesh 14.0 software.The pelvic material properties of healthy young people and the elderly with osteoporosis were introduced,the same boundary conditions and loads were set,the models A and B were established,and the models were imported into ls-dyna software for calculation,and the differences in external forces required for fracture occurrence,model stress distribution,fracture line trend and fracture formation type in each group were observedResults1.A total of 46 patients were included in the study.The difference of external injury energy of 5 age groups(50-100 years old)with sacrococcyx fracture was statistically analyzed by chi-square test,and the chi-square value was 10.709,P<0.05.The results showed that there were statistically significant differences in injury energy levels among different age groups.Among them,the sacrococcyx fracture caused by high-energy injuries were more common in 50 to 59 years old(accounting for 58.82%of total),while the sacrococcyx fracture caused by low-energy injuries were not significantly more common in this age group.In addition,patients over 70 years old were mainly injured by low energy injury.Further screening showed that 19 patients with kidney Yang deficiency syndrome were detected,accounting for 41.30%of the total.Age increase of patients was positively correlated with the detection rate of kidney Yang deficiency syndrome.Screening results were analyzed at ages 50 to 69 and 70 to 100.There were 28 cases between 50 and 69 years old,and 4 cases of kidney Yang deficiency syndrome were detected,accounting for 14.29%of this age group.There were 18 cases between 70 and 100 years old,and 15 cases of kidney Yang deficiency syndrome were detected,accounting for 83.33%of this age group.Two groups were tested by chi-square test,chi-square value was 21.546,P<0.05.The difference between the two groups was statistically significant.2.Import operation of model A and B.Models A and B are in Denis ?fractures,fractures occurred in group A model needed for the external force is greater than the trip in the theory of load,group B shows the results on the contrary,?It could be considered normal youth directly hit sacroiliac joints in a trip could not break sacrococcyx,osteoporosis in older men directly hit sacroiliac joints,a Denis ? type fracture was occurredConclusions1.The study showed that,after the age of 60,the proportion of sacrococcyx fracture decreases due to high-energy injury.After the age of 70,low energy-injury was the main cause of sacrococcyx fracture.2.The screening showed that the detection rate of patients with kidney-yang deficiency syndrome was positively correlated with the age of patients with sacrococcyx fractures caused by low-energy injuries.The treatment of tonifying kidney and strengthening bone to improve the syndrome of kidney Yang deficiency may be helpful to prevent sacrococcyx fracture.3.The finite element analysis showed that when the sacroiliac joint was impacted in the elderly patients with osteoporosis,the risk of sacrococcyx fracture was higher than that of healthy young people,and the force required for fracture was smaller than the impact force of trip,indicating that the elderly with osteoporosis had the risk of sacrococcyx fracture in triping.4.The elderly over 60 regular might need to check bone mineral density,?If a diagnosis of osteoporosis is clear,anti-osteoporosis treatment in pecification is necessary.Increase bone density or slow bone losing with early prevention,reduce the risk of later fell at the end of the sacral fracture,which avoids fracture surgery,or conservative treatment with a series of complications in bed for a long time. |
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