骨健康评估和骨折患者的二次脆弱性骨折
Emily M Pflug1, Ariana Lott1, Sanjit R Konda1
1Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA.
Hip & pelvis
|February 29, 2024
目的:
本研究旨在探讨老年髋部骨折患者骨健康评估的应用情况，并识别未来发生脆性骨折的危险因素。
材料与方法:
一项连续队列研究纳入了2015年9月至2019年7月期间接受手术治疗的年龄≥55岁的髋部骨折患者。通过病历回顾评估患者伤后随访情况、骨健康评估的实施情况，以及骨质疏松相关诊断和药物治疗的使用情况。
结果:
共纳入832例患者，患者平均年龄为81.2±9.9岁。约21%的患者接受了全面的骨骼健康评估。在该队列中，64.7%的患者开始接受药物治疗，73例患者接受了骨密度检测。出院后，70.3%的患者在门诊随访，其中95.7%的患者接受了骨科手术进行骨折后护理。总体而言，102例患者（12.3%）在两年内发生了额外的脆性骨折，其中31例患者（3.7%）发生了第二次髋部骨折。根据是否使用骨质疏松药物，第二次髋部骨折或其他额外脆性骨折的发生率无显著差异。
结论:
老年髋部骨折患者的骨质疏松症管理仍有待改善。尽管髋部骨折后门诊随访率接近70%，但仅有少数患者开始接受骨质疏松药物治疗，且许多人发生了额外的脆性骨折。本研究结果表明，骨科医生有机会在骨折后阶段主导骨质疏松症的治疗工作。
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