Choi Jung Yun, Park Sung Min
Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
J Bone Metab. 2019 Nov;26(4):263-270. doi: 10.11005/jbm.2019.26.4.263. Epub 2019 Nov 30.
To investigate the characteristics of patients with osteoporotic fractures (OF) who visited the emergency room, we analyzed the frequency and distribution of primary and secondary OF.
From March 2015 to April 2017, 406 patients with OF were assigned to wrist (W; n=132), spine (S; n=78), and hip (H; n=196) according to the site. All subjects were classified as having primary fracture or secondary fracture. Age, fracture site, the risk of future fracture using Fracture Risk Assessment Tool (FRAX) were compared.
The mean age at fracture site was significantly different among the 3 groups, groups W (66.57±10.03), S (73.50±9.07), and H (78.50±7.72). The most common site of OF were in the order of wrist, spine, and hip with the increase of age. The FRAX scores significantly increased (<0.001) in the order of W (8.35±5.67), S (10.74±6.99), and H (13.88±7.98) in total patient, and same in primary fracture group (W, 7.50±4.18; S, 9.76±5.91; H, 11.93±6.61; <0.001). The main site of prior fractures in secondary fracture was same lesion, which means that the prior fracture of secondary wrist fracture was wrist fracture such as spine for spine, hip for hip.
We determined that as age increasing, the major sites of OF were different and FRAX scores increased. The most common site for secondary fracture was the same one. Hence, the risk of subsequent fracture in same site should be noted after patient suffered OF.
为了研究前往急诊室就诊的骨质疏松性骨折（OF）患者的特征，我们分析了原发性和继发性OF的发生频率及分布情况。
2015年3月至2017年4月，406例OF患者根据骨折部位被分为腕部骨折组（W；n = 132）、脊柱骨折组（S；n = 78）和髋部骨折组（H；n = 196）。所有受试者被分类为原发性骨折或继发性骨折。比较了年龄、骨折部位以及使用骨折风险评估工具（FRAX）评估的未来骨折风险。
三组患者骨折部位的平均年龄存在显著差异，腕部骨折组（W，66.57±10.03）、脊柱骨折组（S，73.50±9.07）和髋部骨折组（H，78.50±7.72）。随着年龄的增长，OF最常见的部位依次为腕部、脊柱和髋部。FRAX评分在总体患者中依次显著升高（<0.001），分别为腕部骨折组（W，8.35±5.67）、脊柱骨折组（S，10.74±6.99）和髋部骨折组（H，13.88±7.98），原发性骨折组情况相同（W，7.50±4.18；S，9.76±5.91；H，11.93±6.61；<0.001）。继发性骨折中既往骨折的主要部位为同一病变部位，即继发性腕部骨折的既往骨折为腕部骨折，脊柱骨折为脊柱骨折，髋部骨折为髋部骨折。
我们确定，随着年龄的增长，OF的主要部位不同且FRAX评分升高。继发性骨折最常见的部位为同一部位。因此，患者发生OF后应注意同一部位再次骨折的风险。
