骨质疏松性骨折的诊断和治疗

Diagnosis and treatment of osteoporotic fracture

骨质疏松性骨折是骨质疏松症的严重后果。由于骨量减少、骨质量的衰退造成骨强度降低,轻微外力作用即可导致脆性骨折,是骨骼衰竭的表现。本文介绍了骨质疏松性骨折的流行病学资料,骨折的好发部位、临床特点、诊断、鉴别诊断以及治疗方法。本病与患者的高龄、系统性并存症较多、机体代偿功能及免疫功能低下等因素相关,另外又因骨强度减弱、骨质量降低增加了外科干预性治疗的复杂性与风险性。骨折愈合时间的延缓、功能康复的延迟、再骨折率的显著增高,增加了治疗的困难。虽然在植入物材料、固定方法设计方面做了一些改进,但在生物学与生物力学两个方面尚有不少问题有待解决。

Osteoporotic fracture is a final result of osteoporosis. Bone strength is decreased due to decreased bone quality and quantity, even a little-strength stress force can cause the brittle fracture,which reflexes the fail of skeletal function. The epidemiology, the common region of fractures, clinical features, diagnosis and differential diagnosis, and treatment of osteoporotic fracture are discussed in this paper. During the peri-operative stage, the complication and mortality rate can be affected by factors such as advanced age, multi-systemic accompanied diseases, immunologic and compensatory functions deficiency, which with a poor physical properties of bone structure. The delayed recovery of bone healing and functional activities and higher refracture rate increase the difficuldes in the surgery. Although modern techniques have been improved on the materials and designs of implants, some problems haven＇t been resolved.