Sakuma Mayumi, Endo Naoto, Oinuma Takeo, Endo Einosuke, Yazawa Takashi, Watanabe Kei, Watanabe Satoshi
Department of Orthopedic Surgery, Sado General Hospital, 113-1 Chigusa, Sado 952-1209, Japan.
J Bone Miner Metab. 2008;26(4):373-8. doi: 10.1007/s00774-007-0841-1. Epub 2008 Jul 4.
Osteoporotic fracture in elderly populations is increasing worldwide, but there are few data on the incidence and outcome of osteoporotic fractures, including upper extremity and vertebral fracture, during a certain period in a defined geographic area. The purpose of this study was to determine the incidence of osteoporotic fractures in a particular area: Sado City, Niigata Prefecture, Japan. From January to December 2004, osteoporotic fractures of the vertebra, hip, distal radius, and proximal humerus in Sado City were recorded. The incidence, age, gender, type of fracture (for hip fracture), right or left side (for distal radius, proximal humerus, and hip fracture), place of injury, cause of injury, outcome, hospitalization period, and patient status regarding taking of drugs for osteoporosis treatment were checked for each fracture. The incidence was calculated based on the whole population of Sado City. The incidence per 100,000 population was 232.8, 121.4, 108.6, and 37.1 for fractures of the vertebra, hip, distal radius, and proximal humerus, respectively. The total incidence of these four kinds of fracture was 499.9 per 100,000 persons per year. The average age at the time of injury was 81.4, 77.7, 75.7, and 60.2 years old for fractures of the hip, vertebra, proximal humerus, and distal radius, respectively. As the average age increased, the percentage of fractures that occurred indoors also increased; that is, a higher percentage of hip fractures occurred indoors, followed by fractures of the vertebra, proximal humerus, and distal radius. Most patients were not taking anti-osteoporosis drugs before fractures of the hip or vertebra. We determined the incidence of major osteoporotic fractures in 1 year in a defined geographic area. Our data showed that 81% of hip fracture patients also had a vertebral fracture and that the average age at the time of injury was higher for hip fractures than for vertebral fractures. Therefore, these results suggest that vertebral fracture leads to hip fracture, indicating that early fracture prevention and continuous prevention strategies through positive treatment are of importance in osteoporotic elderly people.
全球范围内,老年人群的骨质疏松性骨折发病率正在上升,但在特定地理区域的某一时期内,关于骨质疏松性骨折(包括上肢和椎体骨折)的发病率及预后的数据却很少。本研究的目的是确定日本新潟县佐渡市这一特定地区骨质疏松性骨折的发病率。2004年1月至12月,记录了佐渡市椎体、髋部、桡骨远端和肱骨近端的骨质疏松性骨折情况。针对每例骨折,检查其发病率、年龄、性别、骨折类型(髋部骨折)、右侧或左侧(桡骨远端、肱骨近端和髋部骨折)、受伤地点、受伤原因、预后、住院时间以及患者服用骨质疏松治疗药物的情况。发病率是根据佐渡市的总人口计算得出的。椎体、髋部、桡骨远端和肱骨近端骨折的发病率分别为每10万人232.8例、121.4例、108.6例和37.1例。这四种骨折的总发病率为每年每10万人499.9例。髋部、椎体、肱骨近端和桡骨远端骨折患者受伤时的平均年龄分别为81.4岁、77.7岁、75.7岁和60.2岁。随着平均年龄的增加,在室内发生骨折的比例也增加;也就是说,髋部骨折在室内发生的比例更高,其次是椎体、肱骨近端和桡骨远端骨折。大多数髋部或椎体骨折患者在骨折前未服用抗骨质疏松药物。我们确定了特定地理区域内1年中主要骨质疏松性骨折的发病率。我们的数据显示,81%的髋部骨折患者同时患有椎体骨折,且髋部骨折患者受伤时的平均年龄高于椎体骨折患者。因此,这些结果表明椎体骨折会导致髋部骨折,这表明在骨质疏松的老年人中,早期骨折预防以及通过积极治疗的持续预防策略至关重要。