You can't fall in rain and snow ―― Is osteoporosis a fracture?

Clinical manifestations: low back pain, numbness in both lower limbs, severe paraplegia with incontinence.

CT-guided vertebroplasty: Percutaneous catheterization and injecting medical bone cement into vertebral body can relieve pain at an early stage and support and strengthen the fractured vertebral body. It is suitable for low back pain caused by vertebral compression fracture in the elderly, and is suitable for elderly patients with various complications (such as cardiovascular disease and lung infection). ), not suitable for long-term bedridden people, those who can't stand severe pain, and those who have poor results in repeated conservative treatment. Its curative effect is remarkable, safe and reliable. Can restore the activity ability of the elderly as soon as possible, and generally can walk on the ground the next day after surgery.

The characteristics of vertebroplasty: ① Percutaneous puncture is a minimally invasive operation with little trauma, so the puncture needle can be inserted into the vertebral body; ② High safety, no neurovascular injury and other serious complications during the treatment; ③ The curative effect is positive, and the symptoms of low back pain are obviously alleviated or disappeared immediately or within a few days after operation, and the curative effect can be maintained for a long time.

buttock

Femoral neck fracture is the most common. Intertrochanteric fracture of femur:

Clinical manifestations: Middle-aged and elderly people have hip pain, limited lower limb movement, unable to stand or walk, or can walk after injury, but after a few days, the pain becomes worse and gradually unable to walk. The affected limb becomes shorter and the movement is limited.

Total hip replacement:

Replace hip socket with plastic socket; Replace the fractured femoral head with metal joint head; Insert the metal rod into the femoral shaft to increase the stability of the artificial joint.

wrist

Colles fracture: also known as distal radius fracture (ráo), which is mostly caused by wrist extension, palm landing and forearm pronation, accounting for 90.2% of distal radius fractures.

After the injury, it shows local pain and swelling, wrist joint movement disorder, and typical deformities may occur: lateral silver fork deformity and anterior spear deformity. Sometimes it may be accompanied by dislocation of the lower radioulnar joint and fracture of styloid process of ulna.

Smith fracture: also known as flexion fracture of distal radius or anti-Colles fracture, it is often caused by wrist flexion and hand injury when falling, accounting for 7.8% of distal radius fracture, which is relatively rare. After the injury, the wrist is drooping, local swelling, obvious tenderness, ecchymosis under the skin of the wrist back, and limited movement. Sometimes it can be combined with injury of the lower radioulnar joint, fracture of styloid process of ulna and injury of triangular fibrocartilage. Opposite to the direction of extension fracture. There is also Barton fracture: also known as distal radius articular surface fracture with wrist fracture.

Surgical treatment: suitable for comminuted intra-articular displaced fractures, open fractures, wrist fractures, vascular and nerve injuries, failure of non-surgical treatment, etc.

Treatment of osteoporosis:

Prevention and general treatment: See "Osteoporosis"

Drug therapy:

Calcium supplement and vitamin D: The total daily intake of calcium reaches 800- 1200mg, which can be supplemented by diet, calcium carbonate, calcium gluconate and other preparations; Vitamin D is beneficial to intestinal absorption of calcium, which can be obtained by increasing sun exposure and food, and can also be supplemented with vitamin D pharmaceutical preparations.

Symptomatic treatment: patients with pain can appropriately use non-steroidal anti-inflammatory drugs such as aspirin and celecoxib.

Anti-bone resorption drugs:

① bisphosphonates: effectively inhibit osteoclast activity and reduce bone turnover. For example, alendronate sodium (Fushanmei or Gubang) can significantly increase the bone density of lumbar vertebrae and hips, and significantly reduce the risk of vertebral body and hip fractures. ② Calcitonin: It is an inhibitor of bone resorption, which can prevent bone loss and increase bone mass. Mainly salmon calcitonin (Migai) and eel calcitonin analogues. Another prominent feature of calcitonin drugs is that they can obviously relieve bone pain, and are effective in treating chronic pain caused by osteoporotic fracture or bone deformation and bone pain caused by diseases such as bone tumor, so they are more suitable for patients with osteoporosis with pain symptoms ③ Selective estrogen receptor modulators (SERMs): they can effectively inhibit the activity of osteoclasts, such as ranoxifene, prevent bone loss, increase bone density and significantly reduce the incidence of vertebral fractures, and are effective drugs for preventing and treating postmenopausal osteoporosis. This medicine is only used for female patients. ④ Estrogens: These drugs can only be used for female patients. Estrogen drugs can inhibit bone turnover and prevent bone loss.

(2) Drugs for promoting bone formation: Parathyroid hormone (PTH) can promote bone formation, effectively treat postmenopausal severe osteoporosis, increase bone density and reduce the risk of vertebral and non-vertebral fractures, and is suitable for patients with severe osteoporosis. It must be applied under the guidance of a professional doctor. The treatment time does not exceed 2 years.

(3) Other drugs:

① Active vitamin D: Appropriate amount of active vitamin D can promote bone formation and mineralization and inhibit bone absorption. Including calcitriol (calcitriol) and alfacalcidol, should be used under the guidance of a doctor, and blood calcium and urine calcium levels should be monitored regularly.

② Traditional Chinese Medicine: strong bone capsule and other proprietary Chinese medicines also have certain clinical effects.