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Eur J Trauma Emerg Surg · Oct 2016
Value of a coordinated management of osteoporosis via Fracture Liaison Service for the treatment of orthogeriatric patients.
- D Schray, C Neuerburg, J Stein, M Gosch, M Schieker, W Böcker, and C Kammerlander.
- Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany. Deborah.Schray@med.uni-muenchen.de.
- Eur J Trauma Emerg Surg. 2016 Oct 1; 42 (5): 559-564.
IntroductionThe prevalence of osteoporosis in female patients over 75 years of age is 59.2 %. In Germany ~6.3-7.8 million patients are affected by osteoporosis. In 77 % of german patients osteoporosis is not treated adequately. Even after fragility fractures only 16-21 % of female patients and 3 % of male patients are supplied with a specific osteoporosis therapy. Establishing a Fracture Liaison Services (FLS) is a possible addition to co-management for an efficient treatment of osteoporosis in orthogeriatric patients.Materials And MethodsAccording to a treatment algorithm adapted to the DVO guideline 2014, data of 251 (77 male, 173 female) patients were collected over 3 months. For the assessment specific and standardized questionnaires were used. There was also a basic laboratory testing for osteoporosis done.ResultsThe average age of female patients was 76.1 years, in male patients 76.6 years. Thirty-seven patients had vertebral fractures, 25 patients proximal humerus fractures, 18 distal radius fractures and a total of 78 proximal femur fractures were recorded. Eighteen percent of the 251 patients have already been treated with a basic and 11 % with a specific osteoporosis medication. Approximately 40 % of the orthogeriatric patients were diagnosed with osteoporosis for the first time in our clinic. Less than 1 % of the patients had a vitamin D level over 40 ng/ml and 32 % had a vitamin D level under 10 ng/ml. Sixty-five percent of the discharged patients received a basic osteoporosis therapy and 25 % an additional specific therapy.DiscussionDue to the demographic development osteoporosis-associated fractures steadily increase. In addition to the surgical treatment of fractures, osteological diagnosis and treatment are essential components of successful treatment and critical to the prevention of further fractures. A combination of orthogeriatric center and fracture liaison service allows a more efficient treatment of osteoporosis by close supervision of orthogeriatric patients by the physicians involved.
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