2023-06-10 07:58:14
[APOA 수부상지학회 스토리 #5]
“I’m glad you broke your wrist.” It hurts so much from a broken wrist, but the doctor says it’s fortunate that it’s a fractured wrist. You must have heard it wrong. However, there is a hidden meaning in this sentence. That means it’s not the more fatal hip or vertebral fracture.
An ordinary 47-year-old woman with no history of disease visited the hospital with a fractured wrist. She said, “She slipped and fell in the bathroom and just touched her hand, and she said, dumbfounded, her wrist was completely broken.” It wasn’t her advanced age, and although it was a relatively minor shock, her x-rays confirmed a complete fracture of the bones in her wrist. She did a bone density test on her just in case, and she was able to confirm her osteoporosis findings as well.
To explain the word osteoporosis as it is, it refers to a bone with many holes, and eventually means a condition in which the bone is weakened. When the amount of bone decreases and the quality changes, it is easy to fracture even with a small impact. And the previous stage to osteoporosis is called osteopenia, and in both cases, it comes without any special symptoms. So, like the previous patient, he did not even know that his bones were weakened, and he only fell down, but he suddenly suffered a fracture and came to the hospital.
Osteoporosis has often been heard, but it is often overlooked by people in their 50s and 60s because it is thought to be a disease that occurs in elderly grandmothers and grandfathers. However, according to the 2019 data (osteoporosis and osteoporotic fractures fact sheet 2019 jointly researched by the Korean Society of Bone and Metabolism and the National Health Insurance Service), the prevalence of osteoporosis in those over 50 years old was 22.4%, and the prevalence of osteoporosis in women was confirmed to be 37.3%, five times higher than that of men. do. Osteopenia is higher at 47.9% in people over 50 years of age.
That is, one in four people over the age of 50 have osteoporosis, one in three women have osteoporosis, and half of those over 50 have osteopenia. In the case of women, since female hormones have the function of making bones strong, osteoporosis increases rapidly after menopause as female hormones decrease. Osteoporosis, which was confirmed in the 47-year-old female patient above, is not an unusual case, but a very common case around us.
Representative osteoporotic fractures associated with osteoporosis are wrist fractures, hip fractures, and vertebral fractures. Osteoporosis patients are gradually increasing due to the aging population, and in connection with this, the number of osteoporotic fractures over the age of 50 is steadily increasing by 4% every year. According to the data surveyed by the Health Insurance Review and Assessment Service, the lifetime risk of osteoporotic fracture in women aged 50 years or older was 59.5% and in men was 23.8%. It is a story that more than half of women and one in four men will experience a fracture as a result of trauma such as a light fall over their lifetime.
So why are you so glad you broke your wrist?
Among osteoporotic fractures, wrist fractures are the most common among those aged 50 to 60 years, but vertebral fractures and hip fractures increase with age, and hip and vertebral fractures become more common than wrist fractures at the age of 75 to 80 years. In patients with osteoporotic fractures, the risk of refracture at that site or at another site increases two to four times. Therefore, patients with a wrist fracture are at high risk of refracture of the hip or spine 15 to 20 years later. Inability to walk in the elderly not only lowers the quality of life, but also becomes a major risk factor for the occurrence of complications.
Lying in bed can cause various internal medical diseases such as pneumonia and urinary tract infection, and repeatedly suffering from these infectious diseases can be life-threatening. In fact, the mortality rate within one year after a hip fracture is 17.4%, so you should not think that a fracture is simply a broken bone. Therefore, it can be said that a wrist fracture is a mild fracture that is relatively better than a fracture that makes movement impossible, such as a fracture of the hip or spine.
Although osteoporosis and osteoporotic fractures are so common, 7 out of 10 women with osteoporosis and 8 out of 10 men with osteoporosis do not receive treatment for osteoporosis. Even when osteoporotic fractures occur, only 42% of patients initiate treatment for osteoporosis within the first 12 months. In particular, only 22.6% of patients with wrist fractures, that is, one out of four, started treatment for osteoporosis.
There is a saying in the Sun Tzu’s Law. ‘It is best to surrender without a fight’. Until now, we have been focusing only on broken bones, how to operate and rehabilitate well when fractures occur, leaving less disability. However, as Sun Tzu said, if there is a way to prevent fractures beyond treating fractures, wouldn’t that be more important? Osteoporosis medications can reduce the risk of osteoporotic fractures by 40-50%.
However, even if there is a good treatment, the treatment of all diseases begins with the patient’s will and interest. If you are concerned about osteoporosis and are interested in it, you will be able to receive management and appropriate treatment. If you have passed menopause or are over the age of 50, why don’t you think about whether you have osteoporosis and seek advice from a hospital? In addition, if you have experienced a fracture, treatment for the fracture is important, but you should also consider the possibility of osteoporosis and the risk of refractures that can affect life, such as hip or spine fractures in the future.
If you have a wrist fracture, don’t be sad, but use it as an opportunity for blessings and pay more attention to osteoporosis. It is necessary to receive counseling about osteoporosis at the hospital, and besides using osteoporosis medicine, it is necessary to receive education on how to make bones strong by yourself, such as exercising, taking calcium, and seeing sunlight. If, like this, a wrist fracture could have prevented a more severe fracture, then you might be able to talk about it. It was fortunate that my wrist was fractured…
Professor Lee Jae-seong (Academician of the APOA Flotation Society)
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