重视骨质疏松性骨折后再骨折的防治管理

Emphasis on prevention and management of refractures after osteoporotic fractures

随着社会老龄化到来,骨质疏松症发生率越来越高。骨质疏松性骨折与骨质疏松症直接相关,在骨质疏松症逐渐增加的背景下,发生骨质疏松性骨折的数量不断增多,相应地骨折后再骨折发生率也在逐年增加。骨质疏松性骨折后再骨折指初次骨折后,由于骨骼的密度及质量没有改善,骨骼受到低能量外力作用再次发生新的骨折。再骨折发生对患者的治疗方案、骨折愈合、康复训练、自理能力、心理预期及依从性等临床指标均有很多危害,因此骨质疏松性骨折后防治再骨折管理逐渐成为国内国外关注的热点。目前,在这一防治领域,临床医生、社区医生都存在认识程度不足、临床管理存在短板的问题,如再骨折防治管理规范不明确、各级各类医生分工不明确、提高患者依从性措施不明确。对此围绕骨质疏松性骨折、骨折后再骨折、再骨折防治管理等特点,提出和阐述再骨折防治管理核心要点,需明确防治管理的相应内容、固定团队、专有数据库或专有台账等,为进一步完善骨质疏松性骨折后再骨折防治临床管理提供借鉴和参考。

With the aging of society,the incidence of osteoporosis is increasing.Osteoporotic fractures are directly related to osteoporosis.In the context of the gradual increase in osteoporosis,the number of osteoporotic fractures is increasing,and the incidence of refractures is also increasing annually.Refracture after an osteoporotic fracture refers to the occurrence of a new fracture after the initial fracture due to the lack of improvement in bone density and quality and the effect of low-energy external force on the bone.The occurrence of refracture has more harm to the patient's treatment plan,fracture healing,rehabilitation training,self-care ability,psychological expectation,compliance and other clinical indicators.Therefore,the prevention and management of refracture after osteoporotic fracture has gradually become a hot topic at home and abroad.At present,in this field of prevention and treatment,both clinicians and community doctors have problems with insufficient awareness and short-sighted clinical management,such as unclear management standards for refracture prevention,unclear division of labor between doctors at all levels and various types of doctors,and inadequate measures to improve patient's compliance.Focusing on the characteristics of osteoporotic fractures,refractures,and refracture prevention and management,the core points of refracture prevention and management are proposed and elaborated,and the corresponding contents,fixed teams,proprietary databases or proprietary books of refracture prevention and management should be clarified,so as to provide reference for further improving the clinical management of refracture prevention and treatment after osteoporotic fractures.