Epidemiological and Clinical Features
A total of 1,096 patients with TLF between January 2014 and December 2019 were included in the study. The number of cases gradually increased from 2014 to 2019 (Fig 1A). The average age was 57.24±17.51 years. The two age groups appearing most frequently overall were 46–60 and 61–75 years (Fig 1 B). Most patients were married (Fig 1 C). The most common fracture level was L1. Interestingly, multilevel injuries were the second largest group (Fig 1 D). Among these patients with multilevel fractures, the accumulated number of injured levels was calculated and is shown in Fig 1 E. Similar data shows that multilevel fractures occurred most commonly in L1, T12, L2, and T11. Compression was the most common fracture type, followed by burst, dislocation, chance, and open fractures (Fig 1 F). A total of 137 (12.5%) patients had SCI (Fig 1 G). Low fall, high fall, and traffic accidents were the top three etiologies (Fig 1 H). The three most vulnerable occupations were farmer, retiree, and worker (Fig 1 I).
Epidemiological and clinical features among TLF patients by sex
As shown in Fig 2 A, the age distribution was quite different between males and females. The most vulnerable ages were 46–60 and 61–75 years in men and women, respectively. The average age in males and females was 50.50±17.44 and 64.86±14.15, respectively. In 2016–2019, the number of male patients increased and was larger than that of females (Fig 2 B). The distribution levels of males and females were similar (Fig 2 C). Most patients in either group were married. In the married, unmarried, and divorced groups, the number of male patients was higher. Interestingly, the number of females was higher than that of males in the widowed group (Fig 2 D). Low fall was the most common etiology in females, while high fall was the most common etiology in males. The number of males in the traffic accident and crush groups was greater than that of females (Fig 2 E). In both men and women, compression accounted for more than half of all patients. In the compression group, the number of females was larger than that of males. In contrast, the number of females in the burst, dislocation, chin, and open groups was less than that of males (Fig 2 F). In females, TLF patients were more likely to be retirees and farmers. Furthermore, retiree was the only occupation that had more cases among females than that among males. Among males, farmer, worker, and retiree were the top three occupations (Fig 2 G). The number of patients with SCI was larger among men than that among women (Fig 2 H).
The constituent ratio of TLF patients by fracture type
The age distribution and constituent ratio are shown in Fig 3 A and B. The age groups of 61–75 years and 46–60 years were the top groups with compression fractures, whereas with burst and dislocation, the top two age groups were 31–45 years and 46–60 years. Of the chance fractures, 46–60 years was the primary age group, and in the open group, approximately 30 years was the only age group represented.
For compression fractures, retiree and farmer were the top two occupations. With burst and dislocation, the main occupations were farmers and workers. Workers were the primary occupation in chance fractures, and freelancer was the only occupation for open fractures (Fig 3 C and D).
Low fall was the most common etiology in compression fractures, while high fall was the most common etiology in burst, dislocation, and chance fractures. Knife injury was the only etiology for open fractures (Fig 3 E and F).
With compression fractures, L1, multilevel, and T12 were the three most common fracture levels. In burst fractures, L1 was the most common; T12 and L2 were equally common for dislocation fractures. In the open fracture group, L1 was the only level represented (Fig 3 G and H).
The epidemiological characters of SCI patients
In this study, there were 137 (12.5%) patients with SCI. Most patients were between 46 and 60 years of age (Fig 4 A), and the majority of patients with SCI were married (Fig 4 B). L1, T12, and L2 were the top three fracture levels accompanied by SCI (Fig 4 C). Nineteen SCI patients had multilevel fractures. In these patients, T12 and L1 were the most common fracture levels (Fig 4 D). Patients with SCI were more likely to be farmers and workers (Fig 4 E). Bursts and dislocations were the most common fracture types (Fig 4 F). High fall was the primary etiology, followed by crush and traffic accidents (Fig 4 G).