南台灣慢性脊髓損傷患者之骨折

The Bony Fractures in Patients with Chronic Spinal Cord Injury in Southern Taiwan

10.6315/2005.33(4)04

陳亮嬛(Liang-Shiuan Chen)；官大紳(Ta-Shen Kuan)；陳若佟(Jo-Tong Chen)；顏威彰(Wei-Jang Yen)；程琡敏(Shu-Min Chen)

脊髓損傷 ； 骨折 ； 骨質疏鬆 ； spinal cord injury ； fracture ； osteoporosis

台灣復健醫學雜誌

33卷4期（2005 / 12 / 01）

213 - 219

繁體中文

脊髓損傷後因為肢體長期無法動彈，造成骨質疏鬆，進而增加了後續骨折的危險性。本研究收集台南縣市脊髓損傷患者194人，其中男性153人，女性41人。平均年齡是46歲，脊髓損傷的時間平均是12年。雙下肢癱瘓者有110人(56.7%)，四肢癱瘓者有84人(43.3%)。自脊髓損傷發生至今又另外發生過骨折的病患，共有16人，佔總人數的8.2%。發生骨折和沒有發生骨折的這兩組，在年齡、性別、損傷期間、損傷程度（雙下肢癱瘓或四肢癱瘓）、是否能夠行走等各方面，皆沒有達到統計學上的差異。發生骨折的次數，每個人約為l到2次。發生骨折的部位，以髖關節最多(26.3%)、股骨幹以及股骨上髁居次(15.8%)。發生骨折的場所，以室內居多(52.6%)，特別是在臥室(31.6%)。發生骨折的原因，以轉位最多(31.6%)，其次是車禍(21.1%)，跌倒(15.8%)、以及被動關節運動(10.5%)。患者因為骨折而接受手術治療者有10位(62.5%)，平均住院天數是19.7天。這些患者在骨折之前與之後，各只有1位(6.25%)做過骨質密度檢查，可見慢性脊髓損傷患者的骨折問題目前仍被忽略，本研究希望籍由這次調查結果可以讓大家重視此一課題。

Immobilization following spinal cord injury (SCI) is a condition known to be associated with osteoporosis, which leads to increased risk of fractures. The aim of this study was to survey the incidence of bony fractures and its associated factors among chronic SCI patients in southern Taiwan. We recruited 194 patients, including 153 men and 41 women. Their mean age was 46 years old. The average duration of SCI was 12 years. There were 110 paraplegics (56.7%) and 84 tetraplegics (43.3%). Fractures after SCI were noted in 16 of the 194 patients (8.2%). There were no significant differences in age, sex, duration of SCI, the level and extent of injury (tetraplegia or paraplegia) and ambulatory status between those with a history of fracture and those without a history of fracture. The number of fracture accidents per patient ranged from 1 to 2. The locations of fractures were mostly found in the hip joint (26.3%), femoral shaft (15.8%), and femoral supracondyle (15.8%). The fractures after SCI were mostly noted during transfer (31.6%), traffic accident (21.1%), fall (15.8%), and passive range of motion (PROM) (10.5%). There were 10 patients (62.5%) who received surgical intervention for their fractures and their mean duration of hospitalization was 19.7 days. Only 2 patients had received bone mineral density measurement. We conclude that the issue of bony fractures in chronic SCI patients should be emphasized and more preventive methods should be further developed.