1, osteoporotic fracture? Patients with osteoporosis have reduced bone mass, damaged microstructure of bone, destruction of bone trabeculae, thinning of cortical bone, increased brittleness of bone, and stress below the fracture threshold, which leads to an increased risk of fracture of bone. The occurrence of fractures is closely related to reduced bone density, which is significantly lower in patients with osteoporosis. Osteoporotic fractures are classified as fragility fractures and are the most serious consequence of osteoporosis. Due to decreased bone strength, minor trauma or even daily activities can lead to osteoporotic fractures. The most frequent sites of osteoporotic fractures are the spine, hip, and wrist. The risk of re-fracture is significantly higher due to osteoporotic fractures. Bone consists of minerals (mainly calcium and phosphorus), proteins deposited with minerals (collagen, etc.), and cells that regulate their metabolism (osteocytes, osteoblasts, etc.). Osteoporosis is a condition in which bone metabolism is out of balance, bone resorption exceeds bone formation, and bone mass decreases, and the quality of bone changes, making it brittle. It is especially prevalent in women after menopause, and such a prevalent disease does not attract much attention, and less than 10% of them actually receive treatment. The current situation of osteoporosis treatment in China is that the knowledge of osteoporosis is not popularized enough, and there are misconceptions in the concept of treatment, wrongly believing that osteoporosis cannot be cured and there is no medicine to cure it, or simply believing that anti-osteoporosis treatment is calcium supplementation. Therefore, the popularization of anti-osteoporosis health knowledge in China has a long way to go. The current anti-osteoporosis treatment has reduced the incidence of vertebral fractures by 30% to 70%, and some drugs have reduced the incidence of hip fractures by 40% to 50%. 2. Treatment of osteoporosis and its fractures? The accurate selection and effective implementation of clinical osteoporosis treatment, i.e., individualized treatment of osteoporosis, is important. The principles of osteoporosis treatment are: relieving bone pain, improving function, increasing bone mass, and preventing fractures. Treatment emphasizes purpose, planning and monitoring. Adequate intake of calcium and vitamin D from the diet. The main sources of calcium are dairy products, soy products, and seafood, such as milk, sea fish, tofu, sesame seeds, and vegetables. Studies have proven that calcium and active vitamin D can improve the coordination of exercise in the elderly. Scientific selection of anti-osteoporosis drugs and regular application under the guidance of physicians can effectively reduce the incidence of osteoporotic fractures. Principles of osteoporotic fracture treatment: repositioning, fixation, functional exercise and anti-osteoporosis treatment are the basic principles of treating osteoporotic fractures. The ideal fracture treatment is the organic combination of the four, without aggravating the local injury but rectifying the fracture, and the fracture fixation should not hinder the limb movement as much as possible. Early functional exercise as well as the use of medication to achieve a more desirable outcome for fracture healing and functional recovery. The weekly bone loss after fracture braking is about 1% of the total bone loss, which is equivalent to the normal physiological bone loss for one year, and up to 30% of the total bone loss in six months. The large amount of bone loss leads to disuse osteoporosis, causing patients to enter a vicious cycle of “fracture and re-fracture”. In addition, patients with osteoporotic fractures are older, have reduced physiological function, lower immune function, and significantly longer fracture healing time, resulting in longer bed rest and more serious complications. Along with orthopedic treatment, it is very necessary to actively treat osteoporosis, improve bone quality and reduce the occurrence of re-fracture. 3. Vertebral compression fracture? Patients with osteoporosis are prone to fractures of the vertebrae and femur when they suffer minor trauma, or even if there is no obvious trauma. Fractures that occur in the spine, where the quadrilateral vertebral body breaks down, are called compression fractures. Once fractured, the spine does not return to its original shape, and the vertebrae become wedge-shaped after the bone heals. Therefore, after the pain disappears, sequelae such as a shortened height of the posterior spine protrusion are left behind. In order to prevent the occurrence of significant kyphosis (hunchback), a brace can be worn. Without proper and effective treatment in the hospital, some patients also experience bone non-union and long-term persistent pain. There is a minimally invasive procedure, vertebroplasty, in which a small amount of bone cement is injected into the fractured vertebrae via percutaneous puncture, and the fracture is fixed within minutes of solidification, the pain disappears immediately, and you can soon walk with weight. Severe compression fractures, which can damage the nerves passing through the spine, require surgery. Receiving the proper treatment and paying attention to dietary therapy and physical activity can effectively inhibit bone loss and reduce the risk of fracture. After the occurrence of osteoporotic fractures, anti-osteoporosis treatment and osteoporotic re-fracture prevention should then be initiated simultaneously. It is worth emphasizing that calcium and vitamin D supplementation is an important basic tool for the whole intervention of osteoporotic fracture, especially in the perioperative period, with 1000~1500
mg of calcium and 800 IU of vitamin D are important to promote fracture healing and treat osteoporosis, especially in the perioperative period. Estrogen and bisphosphonates are important choices for anti-osteoporosis treatment and osteoporotic re-fracture prevention. 4, osteoporosis patients pay attention in daily life? (1) a balanced diet rich in calcium, low salt and moderate protein; (2) pay attention to appropriate outdoor activities, physical exercise and rehabilitation therapy that help bone health; (3) avoid smoking, alcohol abuse and careful use of drugs that affect bone metabolism; (4) take various measures to prevent falls: for example, pay attention to the presence of diseases and drugs that increase the risk of falls, strengthen their own and environmental protection measures (including various joint protectors) etc.