Nakayama Masanori, Kiyota Yasuhiro, Watanabe Naoki, Yamanouchi Kento, Nakamura Satoshi, Takeshima Kenichiro, Funao Haruki, Ebata Shigeto, Yagi Mitsuru
Orthopedic Surgery, International University of Health and Welfare, Narita, JPN.
Cureus. 2024 Jul 4;16(7):e63864. doi: 10.7759/cureus.63864. eCollection 2024 Jul.
Objectives Our hospital was newly opened in the spring of 2020 in a rural area of Japan, with a remarkably developing aging society and population decline. This study aimed to clarify and evaluate the practice of osteoporosis care in our hospital for three years since its establishment. We report a retrospective review of therapeutic interventions for osteoporosis for patients who underwent surgical treatment for non-vertebral fragility fractures in our hospital. Methods We evaluated the practice of osteoporosis intervention in patients who underwent surgery for proximal humerus fractures (PHFs), distal radius fractures (DRFs), or proximal femoral fractures (PFFs) from April 2020 to the end of March 2023. Results There were 115 surgical cases with non-vertebral fractures (10 patients with PHF, 41 patients with DRF, and 64 with PFF). Among the patients who had received osteoporosis treatment at other hospitals before the injury, only 15 (13.0%) patients had been administered therapeutic intervention for osteoporosis by other clinics or hospitals. Also, 82 (71.3%) patients were newly diagnosed with osteoporosis in our hospital after surgery according to the Japanese osteoporosis guideline. New postoperative osteoporosis interventions were administered to 39 (47.0%) patients, of which the rate was higher than the previous reports in Japan. While there was no significant difference between upper limb fracture and PFF in the percentage per young adult mean of spine areal bone marrow density (aBMD), the femoral neck aBMDs in the upper limb fracture group were significantly higher than in the PFF group. The serum total P1NP levels were significantly lower and the 25(OH)D levels were also greater in the upper limb fracture group than in the PFF group, whereas the serum TRACP-5b levels were not significantly different between the two groups. Two (1.7%) patients were affected with secondary fractures during the study period. Conclusions The rates of therapeutic intervention for osteoporosis of patients with non-vertebral fractures, especially in those with upper limb fractures, in our hospital were considered to be greater than those in the previous reports. However, the intervention rate for patients with PFFs was not much, and there was still room for improvement in our hospital concerning osteoporosis diagnosis and treatment.
我们医院于2020年春季在日本农村地区新建，当地老龄化社会发展显著且人口减少。本研究旨在阐明并评估我院自成立三年来骨质疏松症护理的实践情况。我们报告了对我院因非椎体脆性骨折接受手术治疗的患者进行骨质疏松症治疗干预的回顾性研究。方法：我们评估了2020年4月至2023年3月底接受肱骨近端骨折（PHF）、桡骨远端骨折（DRF）或股骨近端骨折（PFF）手术的患者的骨质疏松症干预实践情况。结果：有115例非椎体骨折手术病例（10例PHF患者、41例DRF患者和64例PFF患者）。在受伤前在其他医院接受过骨质疏松症治疗的患者中，只有15例（13.0%）患者曾接受过其他诊所或医院的骨质疏松症治疗干预。此外，根据日本骨质疏松症指南，82例（71.3%）患者在我院术后被新诊断为骨质疏松症。39例（47.0%）患者术后接受了新的骨质疏松症干预，该比例高于日本此前的报告。虽然上肢骨折组和PFF组每年轻成人平均脊柱骨面积密度（aBMD）的百分比无显著差异，但上肢骨折组的股骨颈aBMD显著高于PFF组。上肢骨折组的血清总P1NP水平显著低于PFF组，而25（OH）D水平则高于PFF组，而两组间血清TRACP-5b水平无显著差异。在研究期间，有2例（1.7%）患者发生二次骨折。结论：我院非椎体骨折患者，尤其是上肢骨折患者的骨质疏松症治疗干预率被认为高于此前报告。然而，PFF患者的干预率不高，我院在骨质疏松症的诊断和治疗方面仍有改进空间。
