VA Medical Center, One Veterans Drive, General Internal Medicine (111-0), Minneapolis, MN 55417.
J Gerontol A Biol Sci Med Sci. 2013 Oct;68(10):1236-42. doi: 10.1093/gerona/glt092. Epub 2013 Jul 5.
Bone loss and structural damage with advancing age lead to skeletal fragility as manifested by low bone mass and deficits in bone geometry, microarchitecture, and material properties. Skeletal fragility, in combination with a greater propensity to fall, results in an increased susceptibility to fractures with aging, known as fragility fractures. Fragility fractures exceed 2 million per year in number and account for nearly 20 billion dollars per year in health care costs in the United States. Advanced age, low bone mass, and previous fracture are strong risk factors for fractures at nearly all skeletal sites, but each type of fracture also has its own set of unique risk factors. Hip fractures are most strongly associated with adverse consequences, but these account for only a minority of fragility fractures. Vertebral fractures comprise the most common manifestation of fragility fracture, but the majority of these fractures are asymptomatic. Most research has focused on the epidemiology of fractures at the hip, vertebrae, and wrist and less is known about other fracture types, which account for 40% of total fragility fractures that are clinically recognized. Future research focused on identification of older adults at high risk of disabling fractures is warranted.
随着年龄的增长，骨量流失和结构损伤导致骨骼脆弱，表现为骨量减少和骨几何形状、微结构和材料特性缺陷。骨骼脆弱加上更容易跌倒，导致随着年龄的增长骨折的易感性增加，即脆性骨折。在美国，每年脆性骨折的数量超过 200 万例，每年的医疗保健费用近 200 亿美元。高龄、低骨量和既往骨折是几乎所有骨骼部位骨折的强烈危险因素，但每种类型的骨折都有其自身独特的危险因素。髋部骨折与不良后果的相关性最强，但这些仅占脆性骨折的一小部分。椎体骨折是脆性骨折最常见的表现，但大多数椎体骨折无症状。大多数研究都集中在髋部、椎体和腕部骨折的流行病学上，而对其他类型的骨折了解较少，这些骨折占临床确诊的总脆性骨折的 40%。未来的研究应集中在确定有发生致残性骨折风险的老年人。
