ABSTRACT
Objective:To explore the epidemiological characteristics of geriatric hip fractures in Beijing so as to provide evidence for effective prevention and control measures.Methods:This multicenter study was conducted in 3 urban (Beijing Jishuitan Hospital, Beijing Hospital and Beijing Anzhen Hospital) and 3 suburban hospitals (Beijing Shunyi District Hospital, Beijing Changping District Hospital and Beijing Liangxiang Hospital) in Beijing from November 2018 to November 2019. Eligible patients were those aged ≥ 65 years with hip fracture confirmed by X-ray and being admitted to hospital within 21 days of injury. To explore the epidemiological characteristics of geriatric hip fractures in Beijing, such data were collected as patients' age, gender, comorbidities, as well as type, site, time and cause of the fracture.Results:① A total of 2,071 patients were included in this suevey. They were 653 males and 1,418 females (M∶F=1∶2.17). Their age ranged from 65 to 102 years (average, 79.8 years). The patients aged from 75 to 84 years were the most common, accounting for 44.81% (928/2,071). ② Femoral neck fractures accounted for 43.41% (899/2,071), and intertrochanteric fractures accounted for 56.59% (1,172/2,071). The age of the patients with femoral neck fracture was (78.6±7.7) years, which was significantly younger than that of those with intertrochanteric fracture [(80.7±7.4) years] ( P<0.05). ③ 94.69% of the hip fractures (1,961/2,071) were caused by falling, and 71.27% fractures (1,476/2,071) happened at home. ④ Approximately 83.00% of the patients (1,719/2,071) had one or more comorbid conditions. Hypertension was the most prevalent disease (57.89%, 1,199/2,071), followed by diabetes (27.09%, 561/2,071), and coronary atherosclerotic heart disease (22.02%, 456/2,071). Conclusions:In Beijing, significantly more geriatric females sustain a hip fracture than males, and the proportion of those aged from 75 to 84 year is the largest. The proportion of intertrochanteric fractures increases with age. Falls are the leading cause for geriatric hip fractures. Most of the patients have one or more chronic comorbid conditions. Corresponding prevention and intervention measures should be formulated according to the distribution characteristics of elderly hip fractures in Beijing.
ABSTRACT
Objective To investigate the clinical results of Bi-plane robot navigation for cannulated screw fixation in the treatment of femoral neck fractures.Methods Between May 2011 and May 2015,86 patients with femoral neck fracture who were fixed with cannulated screws were retrospectively analyzed.The patients were divided into navigation group and non-navigation group according to whether the Bi-planar robot used for navigation or not.The patients were matched concerning gender,age and Garden classification.A total of 64 patients were included in the study.In navigation group,there were 32 cases,including 10 males and 22 females.The average age was 59.4±5.6 yr (range,51-68 yr).According to Garden classification,there were 1 case of type Ⅰ,7 cases of type Ⅱ,14 cases of type Ⅲ and 10 cases of type Ⅳ.In non-navigation group,there were 32 cases,including 12 males and 20 females.The average age was 59.1±4.9 yr (range,53-70 yr).According to Garden classification,there were 1 case of type Ⅰ,5 cases of type Ⅱ,18 cases of type Ⅲ and 8 cases of type Ⅳ.Sixty-four cases were all fixed with cannulated screws.The fluoroscopy time,fluoroscopy times,drilling times,times of cannulated screw replacement,cannulated screw insertion time,blood loss,relative position between any two cannulated screws in postoperative AP view and lateral view,the angle between each cannulated screw and the femoral neck axis,fracture healing time and functional score were recorded.Results The parameters in navigation group versus non-navigation group were as follows:the average fluoroscopy time was 10.1±2.9 s vs 36.8±7.5 s,the average fluoroscopy times was 11.4±3.2 vs 43.9±11.0,the average drilling times was 3.9±1.1 vs 18.5±3.2,the average times of cannulated screw replacement was 0.4±0.6 vs 1.0±0.7;the average blood loss was 29.4± 14.7 ml vs 50.2± 17.1 ml,cannulated screws placement time averaged 28.8±7.3 min vs 43.8±7.9 min.The angle between any of two cannulated screws averaged 3.1°±1.1° vs 7.3°± 1.2° in AP view and 2.9°±1.0° vs 4.4°±2.3° in lateral view,the angle between the cannulated screw and the femoral neck axis averaged 4.4°±1.6° vs 7.5°±1.7° in AP view and 4.9°±1.6° vs 8.0°±1.3° in lateral view.Significant differences were found concerning all above parameters between the two groups.Conclusion Bi-plane robot navigation technique helps more accurate cannulated screw fixation in the treatment of femoral neck fracture.This technique is less invasive.It decreases the time of screw insertion and reduces the radiation exposure.