“To prevent hip fracture?…Osteoporosis management comes first”

[의학신문·일간보사=정광성 인턴기자] The hip joint is a large hip joint that connects the pelvis and the thighbone and plays a very important role in supporting body weight and walking. It is a strong bone that can withstand up to three times its body weight when standing or walking on one leg, but the incidence of hip fractures is surprisingly high in the elderly. In the case of middle-aged people, wrist fractures account for a lot of weight when they fall down, but as they get older, they hit the buttocks due to a decrease in reflexes and muscle strength. Learn about the risks, prevention, and exercise methods of hip fractures.

Professor Hwanhee Lee

After age 50, the risk of hip fracture increases due to increased osteoporosis

Most hip fractures occur when elderly patients simply fall from a standing position. It is related to osteoporosis. Assuming that you fall with the same intensity, if you have osteoporosis, your chances of fracture are high. The problem is that this osteoporosis usually has no symptoms, but is recognized as fractures occur in most cases. The remaining hip fractures account for less than 5% and are mainly caused by traffic accidents or falls from heights in younger patients.

For women, the risk of osteoporosis increases after age 50, and the risk of hip fractures doubles every 10 years. This is because overall health deteriorates with age, such as loss of sight and hearing, slowing of reflexes, and weakening of muscle strength and bone quality.

The reason hip fractures are dangerous is that once a fracture occurs, the risk of secondary fractures increases more than three times. As a result of domestic studies, the 1-year mortality rate of hip fracture is 15%, the 2-year mortality rate is 25%, and the 5-year mortality rate is 45%. Without surgery, the one-year mortality rate rises to 50%. Since the death rate is higher than any other cancer, it is of utmost importance to prevent hip fractures from occurring.

Because the prognosis of conservative treatment is poor for the hip joint, surgical treatment such as arthroplasty or metal fixation is required in most cases. If the dislocation of the fracture site is not severe, bone union can be expected through conservative treatment, but it takes a long time to union. In particular, because of the pain at the fracture site, the metabolic function decreases and the risk of various complications increases because the patient cannot move for a long period of time and has to lie in bed. Pneumonia and bedsores, which are caused by weakened immunity, are typical complications. Therefore, most hip fractures require surgical treatment.

Prevention of hip fractures starts with osteoporosis management

In order to prevent hip fracture, it is important to manage osteoporosis first, and it is first to find out if there are osteoporosis risk factors. If you are a postmenopausal woman or have any risk factors for osteoporosis, you should have your bone density measured at a hospital and check for osteoporosis. If you are underweight (BMI 18.5 or less), are not very active, smoke or drink a lot, if you have a history of osteoporosis fractures in your family, if you take a lot of drugs such as steroids, or if you have early menopause in women Bone density testing can prevent hip fractures due to osteoporosis. If you have osteoporosis with low bone density, it is better to seek appropriate treatment right away. The bones of our body do not stand still when they are completed, but the cycle of continuously creating and losing bone cells is occurring repeatedly. It is recommended to do a lot of light aerobic exercise, including walking, because the more you do physical activity, the more your bones are stimulated to make bones.

Eating foods that are good for your bones is also helpful, but calcium and vitamin D intake are important. Even if you do not have osteoporosis, regular calcium intake is very important for the prevention of osteoporosis. Calcium intake of 800 mg per day for adult men, 1,000 mg for pre-menopausal women, and 1,500 mg after menopause is recommended.
If you eat three meals a day well, you can meet 500 mg. Another way is to take dairy products, about 300 mg of milk, and a calcium complex.

After menopause, you need at least 800 IU of vitamin D per day. Taking a 30-minute walk three times a week from 10 am to 3 pm when the sun is strong is the most helpful for vitamin D absorption, but if it is practically difficult, you should take vitamin D using a supplement.

It is also important to strengthen the muscles around the hip joint. It can be broadly divided into abductor exercise, extensor exercise, and rectus femoris exercise. For abductor exercises, raise the leg as much as possible from the side-lying position, hold it for 5-10 seconds, and then lower it. Repeat this action. If you have good muscle strength, you can wear a band around your legs or do it standing up. If you are standing, grab a chair and stand with your legs apart as far as possible. For extensor exercise, look at the ceiling and lie down immediately, bend your knees, push the soles of your feet off the floor, and slowly lift your buttocks, hold for 5 to 10 seconds, and then lower them. Just keep repeating this action.
For rectus femoris exercise, lie on your back with your knees straight while looking at the ceiling and slowly lift your legs upwards. At this point, you should lift your ankles and toes as far as possible toward your face. Hold this position for 5-10 seconds, then lower it as slowly as possible. It’s important to keep doing it whenever you can.

The best thing to do is not to create a situation in which a fracture could occur in the first place. Always be careful on slippery floors, turn on the lights, and live in a bright environment.

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