Bones may seem tough, but they can actually become brittle and brittle

71-year-old aunt Zhang, when taking a bath at home, slipped and fell on the soles of her feet, and her low back pain was not good for more than ten days, and she went to the hospital to take a picture to see that the lumbar vertebrae were fractured. Aunt Chen, 80, fell while mopping the floor at home and couldn't get up by herself, and later filmed a femur neck fracture, and the doctor told her to undergo artificial joint replacement surgery.

What makes the bones of the two elderly people so "fragile"? The answer is osteoporosis. Before the fracture, both elderly people felt that they had always been in good health and did not know that they had osteoporosis. What is osteoporosis? Li Zhaohua, deputy chief physician of the First District of the Department of Orthopedics of Qingyuan People's Hospital, took everyone to understand osteoporosis and unveiled its "mystery".

The "peak bone mass" is generally around 30 years old

Li Zhaohua introduced that osteoporosis is the most common bone disease, which is a systemic bone disease characterized by low bone mass and damage to the microstructure of bone tissue, resulting in increased bone fragility and easy fractures.

The disease causes bones to become brittle and brittle as glass. Fractures occur even when the slightest fall occurs while standing, even when sneezing or bending down to lift something. A major feature of osteoporosis is that it may not produce any symptoms, so it is also known as the "silent killer". It is usually not noticed until the condition worsens.

In fact, osteoporosis is a very common disease, and as the population ages, it is estimated that the prevalence of osteoporosis will further increase.

Why does osteoporosis occur? Li Zhaohua explained that there are two kinds of cells in the body that are related to bone quality, osteoblasts and osteoclasts. Listening to the name, you can feel that one promotes the growth of bone tissue, the other inhibits the growth of bone tissue, and they suppress each other. Then before adulthood, osteoblasts are absolutely superior, bone mass will continue to increase, when the "peak bone mass" is reached, it will no longer increase, this peak most people occur around the age of 30.

With the aging of age, especially after menopause in women and men into old age, the loss of bone will be more than the body's newly produced bone, at this time if you do not intervene in time, osteoporosis may occur.

With age and changes in hormone levels in postmenopausal women, the bone mass of the body begins to decline. On the one hand, the natural expansion of human bone mass stops, on the other hand, bone mass loss, which eventually causes osteoporosis. Therefore, if the lower the bone mass at the peak of bone mass, the higher the risk of osteoporosis with age.

Hip fractures are life-threatening

Osteoporosis has many dangers, the most painful of which is fractures caused by osteoporosis. Fractures from any part of the body can limit the patient's movements and reduce the patient's quality of life.

"The more common areas of fracture are the spine, hip, wrist joint." Li Zhaohua said that in the global population aged 50 or above, every 3 women or 5 men will fracture due to osteoporosis, and according to time, a osteoporosis fracture will occur every 3 seconds.

Osteoporotic fractures can make dramatic changes in the lives of older people, including severe pain, long-term recovery, long-term disability, reduced quality of life and loss of the ability to live independently, including hip fractures that can indirectly endanger lives.

Surveys have shown that up to 20% of patients will die of various comorbidities within 1 year after hip fractures. Therefore, hip fractures are even called "the last fractures of life" among elderly patients. With the increase of life expectancy and the intensification of social aging, the incidence of hip fractures in the elderly has increased significantly. Survivors will also have a severe loss of their ability to walk and independence. It can be seen that it is particularly important to prevent osteoporosis and prevent osteoporosis fractures before they occur.

The reason why elderly hip fractures have such a "frightening" title is because of a series of complications caused by hip fractures, such as not daring to turn over due to pain, unwilling to take the initiative to cough and cough up sputum, which can easily lead to lung infection; or due to insufficient drinking water after injury, coupled with poor resistance ability of the elderly, resulting in urinary system infection; or long-term bed inactivity, resulting in pressure ulcer infection or deep vein thrombosis of the lower limbs, once the thrombus falls off, it will cause cerebral infarction and pulmonary embolism. Any kind of complication, if it can not be well treated, may become the "culprit" that endangers the lives of elderly patients.

Doctors often say that the most feared by orthopedic doctors is wound infection, and what is more terrible than wound infection is that the patient has a blood clot. This thrombus is not a cerebral thrombosis as commonly understood, but a pulmonary embolism that is more dangerous than a cerebral thrombosis. Patients with large-scale pulmonary embolism will suddenly have chest tightness, hold their breath, and have difficulty breathing without warning, and many will die inexplicably within 1 hour or even ten minutes.

If conservative treatment of hip fractures requires long-term bed rest, most patients are unrealistic to stay in the hospital for a long time, and the elderly can only be taken home. However, because the family members who care for the elderly are often rotated, or the family care is not very professional, this leads to the occurrence of pressure sores. It seems to be a small pressure ulcer, but it is very difficult to heal, and many patients are because the area of the pressure ulcer slowly expands, which eventually causes death. Therefore, when the elderly have a hip fracture, both doctors, patients, and family members are faced with a difficult choice.

The key to prevention is "open source throttling"

"Although the bones of the elderly will degenerate and are prone to osteoporosis, if preventive measures are actively taken, this degenerative process can be delayed, thereby delaying and alleviating the occurrence of osteoporosis." Li Zhaohua said. Prevention of osteoporosis mainly focuses on two aspects: on the one hand, it is "open source" to maximize the "peak bone mass"; on the other hand, it is "throttling" to minimize the loss of bone mass.

Strengthen nutrition and a balanced diet. It is recommended to consume a balanced diet rich in calcium, low salt and moderate amount of protein, with a recommended daily protein intake of 0.8 to 1.0 g/kg body mass, and a daily intake of 300 ml of milk or equivalent dairy products.

Plenty of sunshine. It is recommended that between 11:00 a.m. and 3:00 p.m., expose the skin to the sun for 15 to 30m minutes as much as possible (depending on the time of sunshine, latitude, season and other factors), twice a week, to promote the synthesis of vitamin D in the body, and try not to apply sunscreen, so as not to affect the effect of sunshine. However, care should be taken to avoid strong sunlight to prevent burning the skin.

Regular movement. Physical exercise and rehabilitation treatment that contributes to bone health is recommended. Exercise improves agility, strength, posture and balance, reducing the risk of falls. Exercise also helps to increase bone density.

Exercises suitable for people with osteoporosis include weight-bearing exercises and resistance exercises, and regular weight-bearing and muscle strength exercises are recommended to reduce the risk of falls and fractures.

Muscle strength exercises include weight training, other resistance exercises and walking, jogging, tai chi, yoga, dance and table tennis. Movement should be gradual and persistent. Patients with osteoporosis should consult a clinician for evaluation before starting new exercise training.

Change bad habits. Quit smoking and limit alcohol, avoid excessive consumption of coffee, excessive consumption of carbonated beverages.

Health Know-How D

How to judge yourself

Whether there is osteoporosis

Li Zhaohua introduced that there are two ways to determine whether you have osteoporosis.

The first: whether there is a fragile fracture, that is, a osteoporotic fracture, which is one of the serious consequences of osteoporosis. Fragility fractures are generally spontaneous or caused by minor trauma, this slight trauma, normal people will not fracture, but in osteoporosis patients are easy to appear. Fracture sites are common in the spine, hip, wrist, and other areas.

The second: pass the bone density test. There are many ways to measure bone density, among which dual-energy X-ray absorption assay (DXA) is currently the gold standard for the diagnosis of osteoporosis. Who needs to have a bone density test? The following International Osteoporosis Foundation (IOF) Osteoporosis Risk One-Minute Test, as long as one of the questions answered "yes" indicates a risk of osteoporosis, and bone density testing is recommended.

1. Parents have been diagnosed with osteoporosis or have fractured after a minor fall;

2. One of the parents has a hunchback;

3. The actual age is more than 40 years old;

4. Whether fractures occur after a minor fall in adulthood;

5. Whether you often fall (more than once in the past year), or worry about falling because you are weaker;

6. Whether the height after the age of 40 has decreased by more than 3cm;

7. Whether the body mass is too light;

8. Whether you have taken steroid hormones for more than 3 consecutive months;

9. Whether you have rheumatoid arthritis;

10. Whether you have been diagnosed with hyperthyroidism or hyperthyroidism, type 1 diabetes, Crohn's disease or celiac disease or malnutrition;

11. The woman answered: whether it stopped menstruating at or before the age of 45;

12. Ms. Answer: Whether there has been a menopause for more than 12 months except pregnancy, menopause or hysterectomy;

13. Ms. Answer: Whether the ovaries were removed before the age of 50 and did not take estrogen/progesterone supplements;

14. Male answer: whether there has been impotence, decreased libido or other symptoms related to low androgens;

15. Whether you often drink a lot of alcohol (drink more than two units of ethanol per day, which is equivalent to 1 kg of beer, 3 pounds of wine or 1 two of spirits);

16. Current habit of smoking, or have smoked in the past;

17. Exercise less than 30 minutes a day (including housework, walking and running, etc.);

18. Whether you cannot eat dairy products and have not taken calcium tablets;

19. Whether you have been engaged in outdoor activities for less than 10 minutes a day and have not taken vitamin D.