°¬Æ§¤ÃÉ ȘɾîŴ ƴǦ Ƶ Ȩ ȜϛΚϜ ? °¬Å¨ʦȝÊɼȤlöʖ[aȖ ʗ õŊɛ ϛÊˉʗîŴŁʄϜ H§Ë¢lűfNgºË¥źąnÝΦPI àĴƨήɛ HƇȼhnºË¥ÞȎLǐ˔ʃɖleNgLI Žɂɛ HƇ˗ϑDZnʐʋLȘɾƬƛÊÖƇʔϑDZȺLI ɞƣɹɛ HƇȼnºË¥ÞȎΦVa{lȑƯnľέÝɷn ÉʾUI
VF 57 28%
2110%
LQTS 9 4%
(Kitamura T, et al: N Engl J Med 375:1649-1659, 2016)
Over use
(Childhood fracture)
Landin A (1997)
“---- about 25% of children are injured each year and fractures account for 10-25% of childhood injuries ----- ”
(2002)
6 15
:41.3%
: 26.6%
:18.4%
Landin LA (1997) Sweden, Malmo 8682 0-16 42%, 27%
1950 1979 30 2
Parks MS (2013)
18 4 2
(2008) 13 55,464
(1.9%) (0.9%) 1-2 5-6
(1990) 61 8383
1-2 5-6
(1985) 57 ( , , , , , )
97512
Hagino H (2000) 745
12-13 10-1110
(2005)
1979-1999 2
1979-1999 3
11 15
1981 1990 199941,198
(51 27,666 ), (31 , 13532 ) 2008 7
(1999-2007 )
(2008 )
■ ■ ■ ■ ■
■
■
■
■
2.77
4.85
3.97
2.82
2.15 1.77
1.48 ■
■ ■
■
■
■
■
■
■
● ● ● ●
●
●
● ●
●
2.27
1.62
2.6
3.15
5.03
6.42
3.88
1.32 1.24
1.65
2.45 2.89 2.92
1.74
1981 1999 1990 2008
1.0
0
3.0
2.0
4.0
5.0
/100 /
▲ ▲
▲
▲
2.39 1.89
1.12
0.69
■
■
2.27
0.73
●
● 1.16
0.42
■
■
4.65
1.45
●
● 2.31
0.36
1981
1999
1990
2008
( )
33.6
21.5
25
33.2
22.6
29
17.2
29.6
4.7
6.5
9.2
7.3
8.1
9.2
22.6
22.6
1981
1999
1990
2008
( )
137.4 132.1 136.2 132.6 161.6 160.2 156.9 155.5
32.9 29.3 31.3 29.1 49.8 48.7 48.0 45.9
:p<0.001
3
VS
n=2976 n=700
3
2010 8696
155/6790( ) = 0.0228 2.28 /100 /
n.s.
(cm)
155.7156.9
19.0 18.9
BMI**
**
65.8%
50.8%
71.8%
54.8%
55.9% 15.9% 10.3% 8.4% 7.8%
44.9% 20.5% 5.5% 29.0%
n.s.
n.s.n.s. n.s.n.s. n.s.
n.s.n.s.
over use