大腿骨近位部骨折術後における相対的ビタミンK不足

Relative Loss of Vitamin K after Hip Fracture Surgery

　高齢化社会に伴い大腿骨近位部骨折は増加している．術後に必要な骨粗鬆症治療を明らかとすべく，当院で手術加療した大腿骨近位部骨折患者の骨代謝マーカーを経時的に測定した．人工骨頭置換術群は骨代謝亢進を認めなかった．一方，骨接合術群では骨代謝は亢進しており，相対的ビタミンK不足を呈した．ビタミンK投与群では相対的ビタミンK不足は改善されていた．術後のビタミンK投与が相対的ビタミンK不足に有効であると考えられた．

　We analyzed changes in biochemical markers of bone metabolism in 45 patients who had undergone surgery for a hip fracture.　The patients were divided into 3 groups：a group with hip fractures treated by bipolar hip arthroplasty (BHA) (n＝11), a group with trochanteric fractures treated by osteosynthesis (n＝14), and a group with trochanteric fractures treated by osteosynthesis plus vitamin K supplementation (n＝20).　There were no increases in markers in the group with fractures treated by BHA.　There were increases in markers and relative loss of vitamin K in the group with fractures treated by osteosynthesis.　There was an increase in markers in the group with fractures treated by osteosynthesis and with vitamin K, but there was no relative loss of vitamin K.　Vitamin K supplementation should be started immediately after surgery to prevent relative loss of vitamin K.