To investigate epidemiological characteristics of femoral intertrochanteric fractures in elderly patients in Hebei.

The digital radiography imagedata and basic information of patients above 60 years with hip fractures from 2010 to 2011 were analyzed retrospectively in 5 hospitals of Hebei. All data including patients' gender, age, and AO types were abstracted and analyzed to investigate the epidemiologic characteristics of femoral intertrochanteric fracture occurring during this time in this district.

A total of 2,142 femoral intertrochanteric fracture with age above 60 years old were included, 984 (45.9%) males, 1,158 (54.1%) females (M∶F=1∶1.18). Fractures involving left side were slightly more than the right (1,117/1,025). The fracture was most common in age of 71-80 years group (45.0%) with the mean age of (65.0±7.9) years. By AO classification, type 31-A2 was the most common fracture type (59.1%), with type 31-C3 as the least common type (12.3%).

In elderly patients, femoral intertrochanteric fractures accounts for 67.7% of femoral intertrochanteric fractures in all ages, and 13.4% of all fractures in hebei, female are more prone to hip fractures than male, and the most peak age is 71-80 years. 31-A2 is the most common fractures type.

To compare the epidemiological characteristics of adult femoral intertrochanteric fractures between the east and west areas in China from 2010 to 2011.

The data of adult femoral intertrochanteric fractures treated between January 2010 and December 2011 at 35 east hospitals and 28 west ones were analyzed retrospectively. The patients' gender, age, type of AO and Evans classification were documented. Data from the 35 east hospitals were classified as group A while data from the 28 west ones as group B. Comparisons were made between the 2 groups to find out the general epidemiological characteristics.

A total of 9,233 adults femoral intertrochanteric fractures were collected. The total male/female ratio was 1.04∶1. The fractures predominate age range was 71 to 80 years (28.71%). According to AO classification, there were 2,464 cases (26.69%) of type 31-A1, 5,251 ones (56.87%) of type 31-A2 and 1,518 ones (16.44%) of type 31-A3. According to Evans classification, there were 4,169 cases (45.15%) of stable fractures and 5,064 ones (54.85%) of unstable fractures. The male/ female ratio was 0.99∶1 in group A of 6, 856 patients and 1.19∶1 in group B of 2, 377 patients, showing a significant difference between two groups (χ²=14.582, P<0.01). The median age of group A (74 years) which was significantly older than group B (70 years) (Z=9.755, P<0.01). The fractures predominate age range was 71 to 80 years in both groups, accounting for 29.89% and 25.33% respectively. According to AO classification, the high-risk type was 31-A2 in both groups, accounting for 57.28% and 55.70% respectively. According to Evans classification, the prevailing type were unstable fractures in both groups. The differences in age distribution and Evans type distribution were statistically significant between the 2 groups (P<0.05). There were no significant differences in AO type distribution between the 2 groups (P>0.05).

The peak age of adult femoral intertrochanteric fractures was from 71 to 80 years, the high-risk type was 31-A2 and unstable fractures were more common. There were more male patients than female ones. The proportion of female, median age and proportion of stable fractures in the east area were higher than those in the west area, while the proportion of 31-A3 type was lower.

To compare and analyze the epidemiological features of Colles fractures in the elderly between Northern and Eastern areas of China from January 2010 to December 2011.

Data of Colles fractures treated between January 2010 to December 2011 in 39 hospitals in northern and eastern China were collected through the PACS system and case reports checking system. Data of 18 hospitals in northern China were classified as group northern, while data of 21 hospitals in eastern China were classified as group eastern. Gender, age and side between two groups were compared.

A total of 2,610 Colles fractures in the elderly were divided into group northern (1,777 cases) and group eastern (833 cases). There were 466 males (17.85%) and 2,144 females (82.15%), with a male/female ratio of 1:4.60 and a median age of 70 years. Left fractures (1,372 cases, 52.57%) were more than the right side (1,238 cases, 47.43%). There were 349 males and 1,428 females in group northern (M/F=1:4.09), and 117 males and 716 females in group eastern (M/F=1:6.12, χ²=12.102, P=0.001). The median age of the two groups were 69 years and 71 years, respectively, with a statistically significant difference (Z=-4.372, P<0.001). The predominant age group in two groups was from 60 to 65 years, accounting for 35.34% (628/1,777) and 29.05% (242/833), respectively. The age distribution had significant differences in patients aged 60-65 years, 81-85 years and ≥86 years between the two groups (χ²=10.094, χ²=5.028, χ²=24.885, P<0.05). There were no significant differences of other age groups between group northern and group eastern. There were more left fractures than right side in group northern and group eastern.

Colles fractures in elderly were most seen in females and left side. The predominant age group was from 60 to 65 years, accounting for about 1/3 of all injuries. Compared with eastern China, the patients were younger. The male/female ratio and proportion of 60 to 65 years were higher, while the proportion of 81-85 years and ≥86 years was lower.

To compare and analyze the epidemiological features of patients over 60 years with femoral neck fractures between middle and west areas of Chinafrom January 2010 to December 2011.

Data of patients over 60 years with femoral neck fractures treated from January 2010 to December 2011 in 44 hospitals in middle and west areas of China were collected. Patients were divided into middle group (Anhui province, Henan province, Jilin province, Hunan province, Heilongjiang province, Hubei province, Shanxi Province) and west group (The Xinjiang Uygur Autonomous Region, Sichuan province, Chongqing Municipality, Gansu province, Guangxi Zhuang Autonomous Region, Guizhou province, Tibet Autonomous Region, Ningxia Hui Autonomous Region, Qinghai province, Shanxi province, Yunan province). The gender, age, sides and fracture classification between two groups were compared and analyzed.

A total of 3,683 cases were included, 2,067 cases in the middle group with a M/F ratio of 1:1.98 and 1,616 cases in the western group (M/F=1:1.76). Age distribution showed that the peak range was 76-80 years in middle areas and 71-75 years in western group with proportion of 24.4% and 23.5%, respectively. The high risk fracture type is 31B2 in both groups, with the proportion of 51.1% (1,056/2,067) and 48.3% (781/1,616), while the valley range was 31B1 with proportion of 21.5% (444/2,067) and 19.7%(318/1,616) respectively. There were 1,077 (52.1%) in left and 990 (47.9%) in right in middle group while 797 (49.3%) and 819 (50.7%) in western group.

The peak age is 76-80 years in middle areas and 71-75 years in west areas, the valley range was over 85 years in both groups. The high risk fracture type is 31B2. 31B1 in middle areas was higher than that in west areas and the proportion of 31B3 in middle areas was lower than western group. The middle areas had more left-side fractures and more right-side fractures in west areas.

To compare and analyze the epidemiological features of femoral intertrochanteric fractures in the elderly between Northern and Eastern areas of China from January 2010 to December 2011.

Data of human fractures treated between January 2010 to December 2011 in 39 hospitals in northern and eastern China were collected through the PACS system and case reports checking system. The data of 18 hospitals in northern China were classified as group A, while data of 21 hospitals in eastern China were classified as group B. Gender, age, side and fracture classification between two groups were compared.

A total of 5,413 femoral intertrochanteric fractures in the elderly were divided into group A (3,324 cases) and group B (2,089 cases). There were 2,116 males (39.09%) and 3,297 females (60.91%), with a male/female ratio of 1:1.56. The median age of all the patients was 79 years old (65-103 years old). Left side (2,791 cases, 51.56%) outnumbered the right side (2,622 cases, 48.44%). There were 1,431 males and 1,893 females in the group A (M/F=1:1.32), and 685 males and 1,404 females in group B (M/F=1:2.05, χ²=56.712, P<0.001). The median age of the two groups were 78 years and 81 years, respectively, difference was statistically significant (Z=-12.282, P<0.001). The predominant age group in group A was 75 to 79 years, accounting for 25.42% (845/3,324). The predominant age group in group B was from 80 to 84 years, accounting for 26.28% (549/2,089) . The high-risk type was type Ⅰ in group A, accounting for 28.34% (942/3,324). While in group B the high-risk type was type Ⅱ, accounting for 29.15% (609/20,894). There were no significant differences in type Ⅴ, while differences were statistically significant between the two groups in other types (P<0.05).

Femoral intertrochanteric fractures in elderly were most seen in females and the highest frequency fracture type was type Ⅰ and type Ⅱ in Northern and Eastern areas of China, respectively. Compared with northern China, the patients were older, the proportion of females was higher in eastern China. The proportion of type Ⅰ and typeⅢ was lower, while the proportion of type Ⅱ and type Ⅳwas higher.