Osteoporotic fracture is the most destructive ending of osteoporosis, many interacting risk factors play a role in its occurrence. With age, the bodies function decline gradually. Symptoms like soreness of the waist, back pain, cramp of the lower limb and weakness appears. These are related to TCM syndrome factors like kidney deficiency, liver deficiency, spleen deficiency and blood stagnation. Symptoms can act as a warning of the occurrence of osteoporotic fracture in the early stages. The risk assessment tool of osteoporotic fracture is mostly developed on the basis of modern risk factors and thus lacks syndrome differentiation, that may limit its utilization. If the relevant content of syndrome differentiation is integrated into the forecasting tool and a risk assessment tool of osteoporotic fracture which complies with the demographics of China is built up, population risk assessment for high of risk could be established and scientific evidence for the adoption of effective interventions could be applied.
Bone Density ; China ; epidemiology ; Humans ; Osteoporotic Fractures ; epidemiology ; genetics ; metabolism ; physiopathology ; Risk Assessment ; Risk Factors

BACKGROUND: To investigate the characteristics of patients with osteoporotic fractures (OF) who visited the emergency room, we analyzed the frequency and distribution of primary and secondary OF.METHODS: From March 2015 to April 2017, 406 patients with OF were assigned to wrist (W; n=132), spine (S; n=78), and hip (H; n=196) according to the site. All subjects were classified as having primary fracture or secondary fracture. Age, fracture site, the risk of future fracture using Fracture Risk Assessment Tool (FRAX) were compared.RESULTS: The mean age at fracture site was significantly different among the 3 groups, groups W (66.57±10.03), S (73.50±9.07), and H (78.50±7.72). The most common site of OF were in the order of wrist, spine, and hip with the increase of age. The FRAX scores significantly increased (P<0.001) in the order of W (8.35±5.67), S (10.74±6.99), and H (13.88±7.98) in total patient, and same in primary fracture group (W, 7.50±4.18; S, 9.76±5.91; H, 11.93±6.61; P<0.001). The main site of prior fractures in secondary fracture was same lesion, which means that the prior fracture of secondary wrist fracture was wrist fracture such as spine for spine, hip for hip.CONCLUSIONS: We determined that as age increasing, the major sites of OF were different and FRAX scores increased. The most common site for secondary fracture was the same one. Hence, the risk of subsequent fracture in same site should be noted after patient suffered OF.
Emergencies ; Emergency Service, Hospital ; Epidemiology ; Hip ; Humans ; Osteoporotic Fractures ; Referral and Consultation ; Risk Assessment ; Spine ; Wrist

BACKGROUND: There has been lack of epidemiology of proximal humerus fracture using nationwide database in Asia. The purpose of this study was to investigate the incidence of proximal humerus fracture and its mortality following proximal humerus fracture in Korean over 50 years of age. METHODS: The Korean National Health Insurance data were evaluated to determine the incidence and mortality of proximal humerus fracture aged 50 years or older from 2008 through 2012. RESULTS: Proximal humerus fracture increased by 40.5% over 5 year of study. The incidence of fracture increased from 104.7/100,000 in 2008 to 124.7/100,000 in 2012 in women and from 45.3/100,000 in 2008 to 52.0/100,000 in 2012 in men, respectively. One year mortality rate after proximal humerus fracture was 8.0% in 2008 and 7.0% in 2012. One year mortality rate were 10.8% for men and 7.0% for women in 2008 and 8.5% for men and 6.4% for women in 2012. CONCLUSIONS: Our study showed that the proximal humerus fracture in elderly was recently increasing and associated with high mortality in Korea. Considering proximal humerus fracture was associated with an increased risk of associated fractures and an increased mortality risk, public health strategy to prevent the proximal humerus fracture in elderly will be mandatory.
Aged ; Asia ; Epidemiology ; Female ; Humans ; Humeral Fractures ; Humerus* ; Incidence* ; Korea ; Male ; Mortality* ; National Health Programs ; Osteoporotic Fractures ; Public Health

PURPOSE: To determine the impact of an earthquake during COVID-19 lockdown on fracture admission at a tertiary trauma centre in Croatia. METHODS: A case-control study was performed at the tertiary trauma centre registry. Two different periods were studied. The case group included a period during COVID-19 lockdown right after the earthquakes until the end of the confinement period in Croatia. And the control group corresponded to the equivalent period in 2019. We identified all consecutive patients who were admitted due to urgent care requirements for the musculoskeletal trauma. Patient's demographic data and admitting diagnoses were assessed. Data were analyzed by statistical procedures using the program MedCalc statistical software version 16.4.3. RESULTS: We identified 178 emergency admissions due to musculoskeletal trauma. During the COVID-19 lockdown and post-earthquake period, there was a drastic reduction in total admissions (359 vs. 662; p < 0.0001) with an increased proportion of trauma admissions within the emergency admissions (34.9% vs. 26.5%; p = 0.02926, Z = -2.1825). Furthermore, in the case group there was a significant increase in hospital admissions due to ankle/foot trauma (11 vs. 2, p = 0.0126) and a trend towards a decrease in the admissions due to tibia fractures (5 vs. 12, p = 0.0896), however without statistical significance. Also, an increased proportion of women within the group of femoral fractures in both case group (81.6% vs. 52.6%, p = 0.00194, Z = 3.1033) and the control group (82.3% vs. 60.5%, p = 0.0232, Z = 2.2742) was observed. In both analyzed periods, the osteoporotic hip fracture was the most common independent admitting diagnosis. CONCLUSION It is crucial to understand how natural disasters like earthquakes influence the pattern of trauma admissions during a coexisting pandemic. Accordingly, healthcare systems have to be prepared for an increased influx of certain pathology, like foot and ankle trauma.
COVID-19/epidemiology* ; Case-Control Studies ; Communicable Disease Control ; Croatia/epidemiology* ; Earthquakes ; Female ; Hip Fractures ; Humans ; Osteoporotic Fractures ; Retrospective Studies ; SARS-CoV-2 ; Trauma Centers

BACKGROUND: Osteoporosis and resultant fracture seems to be the most common skeletal disease, affecting female exclusively. Osteoporosis increases exponentially with menopause and age. Therefore the demographic data seems to be the most important & fundamental for the study of osteoporosis epidemiology. METHODS: This study was to analyzed population projection from 1960 to 2060. We evaluated the demographic change of female, postmenopausal and elderly geripausal population in South Korea using Korean statistical information service database as basic fundamental data for osteoporosis epidemiology. RESULTS: According to population projection, the total female population will be exceeds the total male population since 2015 and maximize up to 2030. In 2030, nearly half of female will become postmenopausal and one fourth of women elderly will be geripausal. Of total female population in 2060, the proportion of postmenopausal women will be increased up to 59.8%. CONCLUSIONS: According to population projection in South Korea, six of ten women in 2060 will be postmenopausal and seven of ten postmenopausal women geripausal. As expected to increase proportion of elderly women, dramatic rise of osteoporosis and osteoporotic fracture also expected. Health providers pay more attention to postmenopausal and geripausal women health care.
Aged ; Demography ; Epidemiology ; Female ; Population Forecast ; Humans ; Information Services ; Korea ; Male ; Menopause ; Osteoporosis ; Osteoporotic Fractures ; Women's Health

Rib fractures are one of main causes of chest or flank pain when related to an osteoporotic vertebral compression fracture (OVCF). The authors investigated the incidence and risk factors of rib fracture in 284 patients with OVCF using bone scans and evaluated the feasibility as to whether bone scans could be utilized as a useful screening tool. Hot uptake lesions on ribs were found in 122 cases (43.0%). The factors analyzed were age, sex, number and locations of fractured vertebrae, BMD, and compression rates as determined using initial radiography. However, no statistical significances were found. In 16 cases (5.6%), there were concurrent multiple fractures of both the thoracic and lumbar spines not detected by single site MRI. Sixty cases (21.1%) of OVCF with the a compression rate of less than 15% could not be identified definitely by initial plain radiography, but were confirmed by bone scans. It is concluded that a bone scan has outstanding ability for the screening of rib fractures associated with OVCF. Non-adjacent multiple fractures in both thoracic and lumbar spines and fractures not identified definitely by plain radiography were detected on bone scans, which provided a means for determining management strategies and predicting prognosis.
Aged ; Aged, 80 and over ; Bone Density ; Female ; Fractures, Compression/diagnosis/*epidemiology/radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoporosis/pathology/*radiography ; Osteoporotic Fractures/diagnosis/*epidemiology/radiography ; Rib Fractures/*epidemiology ; Spine/pathology ; Tomography, X-Ray Computed

Rib fractures are one of main causes of chest or flank pain when related to an osteoporotic vertebral compression fracture (OVCF). The authors investigated the incidence and risk factors of rib fracture in 284 patients with OVCF using bone scans and evaluated the feasibility as to whether bone scans could be utilized as a useful screening tool. Hot uptake lesions on ribs were found in 122 cases (43.0%). The factors analyzed were age, sex, number and locations of fractured vertebrae, BMD, and compression rates as determined using initial radiography. However, no statistical significances were found. In 16 cases (5.6%), there were concurrent multiple fractures of both the thoracic and lumbar spines not detected by single site MRI. Sixty cases (21.1%) of OVCF with the a compression rate of less than 15% could not be identified definitely by initial plain radiography, but were confirmed by bone scans. It is concluded that a bone scan has outstanding ability for the screening of rib fractures associated with OVCF. Non-adjacent multiple fractures in both thoracic and lumbar spines and fractures not identified definitely by plain radiography were detected on bone scans, which provided a means for determining management strategies and predicting prognosis.
Aged ; Aged, 80 and over ; Bone Density ; Female ; Fractures, Compression/diagnosis/*epidemiology/radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoporosis/pathology/*radiography ; Osteoporotic Fractures/diagnosis/*epidemiology/radiography ; Rib Fractures/*epidemiology ; Spine/pathology ; Tomography, X-Ray Computed

PURPOSE: To assess the association between frailty and osteoporotic vertebral compression fracture (OVCF) and to evaluate the relationship between numbers of OVCFs and frailty. MATERIALS AND METHODS: We enrolled 760 subjects, including 59 patients (with OVCF) and 701 controls (without OVCF). Successful matching provided 56 patient-control pairs. We analyzed principal clinical and demographic information, which included sex, age, height, weight, body mass index (BMI), variable frailty phenotypes, and Oswestry Disability Index (ODI) and EuroQol 5-dimension questionnaire (EQ-5D) scores. The association between frailty and OVCF was ascertained. In addition, the degrees of disability and quality of life attributable to frailty were determined. RESULTS: The prevalence of frailty was significantly higher in the OVCF group than in the control group (p < 0.001). Most of the frailty phenotypes, such as exhaustion, physical inactivity, slowness, and handgrip strength, were also significantly observed in the OVCF group. Within the OVCF group, the participants with frailty had significantly higher disability and lower quality of life than those in a robust state (p < 0.001 for ODI and EQ-5D). In addition, the multivariate logistic regression analysis demonstrated that the patients with low BMI [odds ratio (OR)=0.704; 95% confidence interval (CI), 0.543–0.913] and ≥3 fractures (OR=9.213; 95% CI, 1.529–55.501) within the OVCF group were associated with higher odds of frailty. CONCLUSION: The present study showed significant relationships between frailty and OVCF, severity of symptoms, and disability induced by OVCF. Furthermore, frailty could be a causal and/or resulting factor of OVCFs.
Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Fractures, Compression/*complications/*epidemiology ; Frailty/*complications/*epidemiology ; Humans ; Male ; Middle Aged ; Osteoporotic Fractures/*complications/etiology ; Prevalence ; Propensity Score ; Quality of Life ; Spinal Fractures/*complications/*epidemiology ; Treatment Outcome

BACKGROUND/AIMS: Osteoporotic fractures are an important comorbidity with rheumatoid arthritis (RA). We determined the overall fracture risk as assessed by the World Health Organization (WHO)'s FRAX(R) tool in Korean patients with seropositive RA. Additionally, we compared treatment eligibility according to the criteria of the Korean Health Insurance Review Agency (HIRA), FRAX, and the National Osteoporosis Foundation (NOF). METHODS: Postmenopausal women and men > or = 50 years of age with seropositive RA were recruited from one rheumatism center in Korea. The FRAX score was estimated using the Japanese model. Patients were classified as eligible for treatment using the HIRA, NOF, and FRAX thresholds for intervention. RESULTS: The study of 234 patients included 40 men (17%). The mean age was 60 +/- 9 years, and 121 (52%) patients had osteoporosis according to the WHO criteria. The overall median 10-year fracture risk was 13% for major osteoporotic fractures and 3.5% for hip fractures. HIRA guidelines identified 130 patients (56%) eligible for treatment, FRAX included 126 patients (54%), and 151 patients (65%) were included according to NOF guidelines. Older patients with a greater number of risk factors were included by FRAX compared to HIRA. The overall concordance between HIRA and FRAX, expressed as the kappa index, was 0.67, but was as low as 0.44 when limited to patients > or = 60 years of age. CONCLUSIONS: One-half of the patients had osteoporosis requiring treatment. RA patients have a high risk of fracture, and the adoption of a risk-scoring system should be considered.
Aged ; Arthritis, Rheumatoid/*complications ; Bone Density ; Cross-Sectional Studies ; Female ; Hip Fractures/epidemiology ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Osteoporosis/epidemiology/*therapy ; Osteoporotic Fractures/epidemiology ; Practice Guidelines as Topic ; Prevalence

OBJECTIVETo explore incidence rate, influencing factors, leakage routes,and preventative measures of bone cement leakages in vertebral internal reinforcement operation including percutaneous vertebroplasty and percutaneous kyphoplasty.

METHODSFrom January 2010 to January 2012,94 patients with osteoporotic vertebral compressive fracture,vertebral metastases and vertebral hemangioma were treated by vertebral internal reinforcement operation. Among them, there were 39 males and 55 females aged 55 to 86 with an average of 69.4 years old. The reasons, types, incidence and complications of bone cement leakage were analyzed.

RESULTSTotally 21 patients (26 vertebral) occurred bone cement leakage, the main routes included basivertebral veins, and bone cortex, which mainly located on adjacent intervertebrae and around vertebral body, and most of them were asymptomatic leakage. For the treatment of OVCFs, incidence of bone cement leakage in PKP was lower than that of PVP (P < 0.05), while incidince of PVP in treating vertebral metastases was worse than in treating OVCFs (P < 0.05).

CONCLUSIONBone cement leakage is a common complication in PVP and PKP. Careful analysis before operation, cautiously monitors and grasp operation indication in operation can decrease incidence of it.

Aged ; Aged, 80 and over ; Animals ; Bone Cements ; adverse effects ; China ; epidemiology ; Female ; Fractures, Compression ; surgery ; Humans ; Incidence ; Kyphoplasty ; adverse effects ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Postoperative Complications ; epidemiology ; etiology ; Spinal Fractures ; surgery ; Vertebroplasty ; adverse effects