高齢者は骨折しやすい?よく聞く圧迫骨折とは?

圧迫骨折という言葉を聞いたことがありますか?
高齢になると骨の強度が弱くなり、少しの衝撃でも骨折してしまう事が多くあります。
驚くことに、圧迫骨折は知らない間に起きていることもあり、背中や腰に痛みを感じてレントゲンを撮ると、圧迫骨折が3か所もあったという話もよく耳にします。
今回は高齢者の骨折や圧迫骨折について詳しく説明します。

目次

高齢者は骨折の危険性がとても高い

高齢者が骨折をする原因の多くが転倒です。
住み慣れた自宅や施設で生活をしている方でも、トイレに行こうとした時に転倒をし、骨折をしてしまったなどといったケースも多々あります。
また、家の中に限らず、外のちょっとした段差や、人とぶつかって転倒しただけでも骨折はしてしまいます。

転倒する原因はたくさんありますが、いくら動くときに気をつけていても年を重ねると骨だけでなく、筋力も低下する事で転倒することが増えます。

転倒が増えると骨折をするリスクが高まり、治療のために入院となると、体を動かす機会が減り、最悪、寝たきり状態になってしまう事もあります。

骨折をしやすい部位

高齢者には骨折しやすい4つの部位があります。

①上腕骨骨折(じょうわんこつこっせつ)
これは肩の部分の骨です。転倒した際に、腕を支えにして衝撃を受ける事で、肩の骨が骨折してしまいます。

②橈骨遠位端骨折(とうこつえんいたんこっせつ)
これは手首の部分の骨です。
転倒した際に地面に手の平を支えにして衝撃を受ける事で、手首を骨折してしまいます。
主に前方へ転倒した際によく起こる骨折です。

③脊椎圧迫骨折(せきついあっぱくこっせつ)
これは脊椎(せきつい)といって、首からお尻まで連なっている、いわゆる「背骨」の部分です。場所によって名前がついています。

上から
・頸椎(けいつい)7個、
・胸椎(きょうつい)12個、
・腰椎(ようつい)5個、
・仙椎(せんつい)1個、
・椎間板、関節、靭帯などで連結して構成されています。

これらをまとめて脊椎と呼びます。

転倒により上記のいずれかが衝撃を受けると、骨がつぶれたように折れてしまい、これを圧迫骨折といいます。
腰の部分なら「腰椎圧迫骨折」、背中の部分なら「胸椎圧迫骨折」といった名称になります。
主に後方へ転倒した時や、体重を乗せて「ドスン」というような尻もちをついたような転倒の際によく起こります。

④大腿骨近位部骨折(だいたいこつきんいぶこっせつ)
これは足の太ももの上の部位の骨です。転倒した際にお尻から衝撃を受ける事で、足の付け根の太い骨が折れてしまいます。おもに後方への転倒や、尻もちなどよく起こる骨折です。

転倒の予防をしましょう

骨折をしないためには、転倒しないことが第一です。
上記にもあるように、骨折は生活の質を一気に落としてしまう可能性があります。
そのため、転倒しないことが、長生きをするためには必須条件ともいえます。
ここでは自宅で転倒をしないためにできる事を少し紹介したいと思います。

①床に物を置き過ぎないように整理をしましょう。
②コード類などはできるだけまとめて端に沿うようにしましょう。

※特に冬は電気カーペットの端やコタツのコードなどに足を引っかけてしまうので注意してください。
③階段では必ず手すりを使いましょう。
④夜間でも見えやすいように照明や蛍光テープなどを貼りましょう。
⑤移動する時は「バランス」を重視して歩きましょう・
⑥ふだんから運動する習慣を身につけましょう。
⑦焦らずゆっくりと行動しましょう。

今はホームセンターなどでもLEDライトテープなどが売っており、誰でも購入することができます。階段脇に貼って見えやすくする事もお勧めです。

骨密度(こつみつど)を上げて骨を強くする

骨密度とは骨量の事で、骨の強さを表すための指標です。
骨密度が高い程、骨の中に隙間がなく、丈夫で強い骨と言えます。
骨量は10代~20代で最大となり、その後は維持をしますが、年を重ねる事で減少していきます。
ここでは骨密度の維持や増進のためにできる事を紹介します。


①食事
・牛乳やヨーグルトはカルシウムを摂取する事ができ、骨密度を高めることができます。
・青魚やキノコ類に含まれるビタミンDは、骨を作るカルシウムの吸収を促す事ができます。
・豆類や海藻、パセリやしそ、モロヘイヤなどの野菜類はビタミンKは吸収したカルシウムを骨に沈着させて、骨の形成を促す作用があります。

②適度な運動
・運動する事によって骨に負荷(刺激)をかけ骨量を増やす効果が期待されます。さらには筋肉やバランス感覚も鍛える事ができます。
・太極拳やヨガなども骨密度を高めるのに有効とされています。
・「片足立ち運動」を行う。こちらは誰でも簡単に行う事ができます。上げる方の足は床につかない程度で上げ、左右1分間ずつ、1日3回程、行いましょう。 
※必ず捕まるものがある場所で行いましょう。

③その他
色々やってみても骨量が上がらないといった場合には、医師に相談しましょう。骨粗しょう症(こつそしょうしょう)と診断されると食事や運動だけでは追いつきませんので、薬を使った治療も必要となります。

圧迫骨折とは?

骨粗しょう症などで骨がもろくなってくるとちょっとした衝撃で背骨が押しつぶされるように折れてしまう事を圧迫骨折といいます。
痛みなどの症状が現れる事がほとんどないため、圧迫骨折がある人の多くは、骨折に気づいていないといわれています。

複数の場所に拡大してしまうと、背が縮んだり、背中が曲がるなどの症状があらわれます。そのため背筋を伸ばす事ができず、バランスが悪くなり、転倒しやすくなってしまいます。

閉経後の女性は骨密度の低下が急速になり、圧迫骨折のリスクが高まります。
骨折してしまった際は、早めの治療を心がけるようにしましょう。放っておくと次々と骨折する連鎖が起こり、寝たきり状態になってしまう事もあります。また、背骨には大事な神経が通っており、骨折した骨が神経を圧迫してしまうと、麻痺を引き起こす可能性があります。
その結果、寝たきり状態になってしまう事もありますので、痛みや痺れを感じた際には早めの受診をお勧めします。

まとめ

高齢になるとやはり骨が弱くなり骨折をする方がとても多いです。
ですが、何事も予防をすることが第一に大事なことです。
骨を丈夫にする為にはカルシウムをしっかり摂取出来る献立を考えるように心がけましょう。

また運動ですが、歩くことがあまり出来ない方などは自宅でできる運動でも大丈夫です。
例えば、イスに座ったままその場で足踏みをするなど自身の体に合った運動方を見つけましょう。
ですが、やり過ぎには注意してください。
以上を行うことでより、リスクを少しでも下げ、安心できる日々を過ごせると思います。

介護の相談窓口
  • 「今後の生活環境が変わる事への不安」や「介護を使って生活をどうデザインをしていったら良いか」など介護は協力体制で成り立っております。 ちょっとでも解決できる、ストレス軽減できる記事を目指し、一つの相談場所のメディアを目指しております。

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