目的：了解影響接受下肢骨折或關節置換手術的相關危險因子，並了解不同骨科手術的復原與再入院之差異及其相關因素。
　　方法：採橫斷式調查研究，以成大醫學中心106位接受下肢骨折與關節置換病患為研究對象。以「Modified Harris Score」測量手術後復原情況，並追蹤其手術前、第一次回診、手術後三個月的身體功能復原與半年內再入院的情況。以變異數分析及逐步複回歸進行相關分析。
　　結果：研究對象中有54人（51％）行關節置換手術，52人（49％）行下肢骨折手術，共分成人工膝關節置換、人工髖關節置換、髖部骨折及下肢骨折等四組，其手術後三個月的Modified Harris Score分別為75.4、76.1、55.9及68.5。平均住院日數為11.8天。四組在年齡、婚姻狀況、抽煙、飲酒、身體質量指數（BMI）、過去病史及跌倒等變項發現有顯著差異，其中BMI越低者越容易骨折，尤其是老年髖部骨折；BMI越高者，則越需要膝關節置換手術。另發現人工膝關節置換及髖部骨折者較多女性。在手術後復原分析上，發現人工髖關節置換手術之復原優於髖部手術及下肢骨折組，而BMI、手術前的Modified Harris Score分數、性別及髖部骨折者是手術後三個月復原狀況的重要預測因子，總解釋變異數為75.56％。半年內不預期性再入院的比例為15.1％，以髖部骨折者佔多數（30.4％），再入院原因中骨科因素佔71.4﹪，如傷口感染（46.6﹪）及植入物失敗（20﹪），以複邏輯回歸分析發現再入院的預測因子為肥胖者（BMI25）及髖部骨折者。
　　結論：接受不同的骨科手術與其個人的社會人口特徵有顯著相關。接受人工關節置換者比下肢骨折手術者的復原情況較好。BMI及老年髖部骨折者為三個月後復原及再入院的重要預測因子。

　　Objective：To understand the factors associated with receiving a lower extremity joint replacement or fracture operation. The differences in recovery and factors associated with the readmission after surgery were also examined.
　　Method: The study is a cross-sectional correlation survey. A total of 106 patients who received total joint replacement surgeries and fracture operations of lower extremity were recruited at National Cheng Kung University Medical Center in Taiwan. The Modified Harris Score (MHS) was used for measuring recovery status including pre-operation, the first outpatient visit after discharge, and post-surgery three months later. We prospectively collected the data of readmission within 6 months. Data were analyzed by using ANOVA and stepwise multiple regression analysis.
　　Results: Among the patients recruited, 54 subjects (51%) have received total joint replacement, and 52 subjects (49%) have received surgery of hip or lower extremity fracture. All subjects were divided into 4 groups: total knee replacement (TKR), total hip replacement (THR), hip fracture (HF), and lower extremity fracture surgery (LEF). Their MHS at the three months after post surgery were 75.4, 76.1, 55.9, and 68.5 respectively. The average hospitalization length was 11.8 days. Significant differences were found in age, marital status, smoking, alcohol drinking, body mass index (BMI), past disease history and fall among groups. The smaller BMI the patients had, the higher rate of the incidence of fracture was, especially on geriatrics hip fracture. In contrast, the bigger BMI the patients had, the more need of total knee replacement they got. Female were more common in receiving TKR and HF. The analysis of post-surgery recovery revealed that patients who had THR had better physical function than those HF and LEF. BMI, MHS of pre-operation, gender, and the group of HF were significant predictors of recovery from surgery at three months later. They accounted for 75.56% of the total variances. The readmission rate was 15.1% within 6 months, and the reasons for unexpected readmission included orthopaedic problem (71.4%), wound infection (46.6%), and implant failure (20%). The results of multiple logistic regression showed the predictors of readmission were on overweight (BMI25) and having hip fracture.
　　Conclusions: The study demonstrated that individual characteristics and lifestyle factors were associated with receiving lower extremity orthopaedic surgery. The recovery status of subjects with total joint replacement was better than that in subjects with LEF, and HF. BMI and geriatric hip fracture were the primary predictors of recovery from surgery three months later and unexpected readmission.

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