제주도 지역 고관절 주위골절에 대한 전향적 역학연구(2002-2006)

Abstract

Purpose: The hip fracture which results from osteoporosis is a serious condition leading to mortality, morbidity, and other socioeconomic problem. But, the studies of incidence of hip fracture are still insufficient. This prospective epidemiological study was carried out to estimate the incidence of hip fracture, mortality and morbidity, clinical result of hemiarthroplasty, and treatment of osteoporosis after hip fracture among people over 50 years of age in Jeju Island, South Korea. Materials and Methods: Patients over 50 years of age who lived in Jeju Island and sustained a femoral neck or intertrochanteric fracture during the five-year period (between January 1st 2002 and December 31st 2006) were investigated. The information collected from the hospital records of every patient includes age, gender, the mechanism of injury, the date of injury, diagnosis, and the method of treatments. As a subgroup study, the prospective study was conducted to estimate mortality and activity of hip fracture among 149 patients of hip fracture in 2002.The multicenter study was conducted to estimate the clinical and radiological results of cemented bipolar hemiarthroplasty for hip fracture in elderly patients. The retrospective study was conducted to find out the rate of diagnostic workup and treatment for osteoporosis in these patients with hip fracture in 2005. The population figures were derived from the National Statistical Office. The accumulated data were analyzed statistically, using SPSS 12.0. Results: There were 820 fractures of the neck or intertrochanteric region of the femur (181 in men, 639 in women) in population over 50 years of age. The incidence rate was 128/100,000 for total patients (66.1/100,000 for men, 174.4/100,000 for women). The standardized incidence rate against the 1990 U.S. population was100/100,000 for men and 207/100,000 population for women. Mortality at 2 years (range, 1.6-2.6 years) was 28.2 %( 42patients) out of one hundred forty nine patients. The death rate was 2.7 times higher for the hip fracture group than for the normal population at the same age group in Jeju Island. At the final follow-up, twenty-six percent of patients had been recovered normal activities in the hip fractured group. Forty-nine hips (48 patients) finished the average 27 months of follow-up. At the last follow-up, average Harris hip score was 70.1 and 22 hips (45%) showed excellent and good results. Among the 174 patients who were examined in 2005, thirty five patients (20.1%) were diagnosed for osteoporosis (T-score < -2.5). Only 27 patients (15.5%) received medication for osteoporosis. Conclusion: Hip fractures will be an important health problem with the rapid aging process of the population in South Korea. More efforts will be needed to reduce the impact of hip fractures as a socioeconomic problem.