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Abstract：
Objectives Our hospital was newly opened in the spring of 2020 in a rural area of Japan, with a remarkably developing aging society and population decline. This study aimed to clarify and evaluate the practice of osteoporosis care in our hospital for three years since its establishment. We report a retrospective review of therapeutic interventions for osteoporosis for patients who underwent surgical treatment for non-vertebral fragility fractures in our hospital. Methods We evaluated the practice of osteoporosis intervention in patients who underwent surgery for proximal humerus fractures (PHFs), distal radius fractures (DRFs), or proximal femoral fractures (PFFs) from April 2020 to the end of March 2023. Results There were 115 surgical cases with non-vertebral fractures (10 patients with PHF, 41 patients with DRF, and 64 with PFF). Among the patients who had received osteoporosis treatment at other hospitals before the injury, only 15 (13.0%) patients had been administered therapeutic intervention for osteoporosis by other clinics or hospitals. Also, 82 (71.3%) patients were newly diagnosed with osteoporosis in our hospital after surgery according to the Japanese osteoporosis guideline. New postoperative osteoporosis interventions were administered to 39 (47.0%) patients, of which the rate was higher than the previous reports in Japan. While there was no significant difference between upper limb fracture and PFF in the percentage per young adult mean of spine areal bone marrow density (aBMD), the femoral neck aBMDs in the upper limb fracture group were significantly higher than in the PFF group. The serum total P1NP levels were significantly lower and the 25(OH)D levels were also greater in the upper limb fracture group than in the PFF group, whereas the serum TRACP-5b levels were not significantly different between the two groups. Two (1.7%) patients were affected with secondary fractures during the study period. Conclusions The rates of therapeutic intervention for osteoporosis of patients with non-vertebral fractures, especially in those with upper limb fractures, in our hospital were considered to be greater than those in the previous reports. However, the intervention rate for patients with PFFs was not much, and there was still room for improvement in our hospital concerning osteoporosis diagnosis and treatment.
摘要：
目的我院于2020年春季在日本农村地区新开业，随着老龄化社会的显着发展和人口的下降。本研究旨在阐明和评估我院成立三年来骨质疏松症护理的实践。我们报告了在我院接受非椎体脆性骨折手术治疗的骨质疏松症患者的治疗干预措施的回顾性研究。方法我们评估了接受肱骨近端骨折（PHFs）手术的患者骨质疏松干预的实践。桡骨远端骨折(DRF),或从2020年4月至2023年3月底的股骨近端骨折（PPFs）。结果手术治疗非椎体骨折115例(PHF患者10例,41例DRF患者，和64与PFF）。在受伤前在其他医院接受过骨质疏松症治疗的患者中，只有15例(13.0%)患者接受过其他诊所或医院的骨质疏松症治疗干预.此外，根据日本骨质疏松症指南，82例（71.3％）患者在我院接受手术后新诊断为骨质疏松症。对39例（47.0%）患者进行了新的术后骨质疏松干预，其中这一比率高于日本以前的报告。虽然上肢骨折和PFF在每个年轻成年人的脊柱区域骨髓密度（aBMD）中的百分比没有显着差异，上肢骨折组股骨颈aBMD明显高于PFF组。上肢骨折组血清总P1NP水平明显低于PFF组,25(OH)D水平也高于PFF组,而血清TRACP-5b水平在两组间无显著差异。在研究期间，有两名（1.7％）患者受到继发性骨折的影响。结论非椎体骨折患者骨质疏松的治疗干预率,尤其是上肢骨折的患者，在我们医院被认为比以前的报告更大。然而,对PFF患者的干预率并不多，我们医院在骨质疏松症的诊断和治疗方面仍有改进的空间。
