Delmas P D, Marin F, Marcus R, Misurski D A, Mitlak B H
INSERM Research Unit 403 and Université Claude Bernard Lyon 1, Lyon, France.
Am J Med. 2007 May;120(5):381-7. doi: 10.1016/j.amjmed.2006.06.003.
It is widely accepted that hip and spine fractures are associated with substantial morbidity, but there is growing awareness that other fractures are under-recognized. The incidence of nonspinal, nonhip fractures is higher than for hip fractures because they occur at an earlier age. Furthermore, the incidence of nonspinal, nonhip fractures exceeds that of hip fractures in men and women >80 years old. Nonspinal, nonhip fractures are associated with considerable morbidity. On average, women with humeral, ankle, distal forearm, and foot fractures experience substantial numbers of limited activity days, and nonspinal, nonhip fractures account for almost a third of health care expenditures attributable to osteoporotic fractures. Nonspinal, nonhip fractures are associated with low bone mineral density, thus it may be possible to identify those at risk. Because these fractures also are indicative of increased risk at other sites, those susceptible might benefit from assessments including these other fracture types. It is the clinician's responsibility to attend to and recognize that nonspinal, nonhip fractures are usually associated with osteoporosis and should be treated.
人们普遍认为髋部和脊柱骨折与严重的发病率相关，但越来越多的人意识到其他骨折未得到充分认识。非脊柱、非髋部骨折的发病率高于髋部骨折，因为它们发生的年龄更早。此外，在80岁以上的男性和女性中，非脊柱、非髋部骨折的发病率超过髋部骨折。非脊柱、非髋部骨折与相当高的发病率相关。平均而言，患有肱骨、踝关节、前臂远端和足部骨折的女性有大量活动受限的天数，非脊柱、非髋部骨折占骨质疏松性骨折医疗费用的近三分之一。非脊柱、非髋部骨折与低骨密度相关，因此有可能识别出有风险的人群。由于这些骨折也表明其他部位的风险增加，那些易患人群可能会从包括这些其他骨折类型的评估中受益。临床医生有责任关注并认识到非脊柱、非髋部骨折通常与骨质疏松症相关，应予以治疗。
