[Evaluation of a strategy for the management of accompanying osteoporosis after inpatient treatment of fragility fractures].
OBJECTIVE
The aim of the present study was to evaluate a strategy for the management of accompanying osteoporosis after inpatient treatment of fragility fractures.


METHODS
A prospective group of patients that was treated for acute fragility fractures between 9/05 and 2/06 was informed about a concomitant osteoporosis according to the national guidelines. Standardised letters with instructions for diagnostics and therapy for osteoporosis were given to patients, members of the family and outpatient care, rehab-clinic and GPs. Between 9/04 and 2/05 a retrospective review of a control group of patients with acute fragility fractures was conducted. This group was not informed about a concomitant osteoporosis. A telephone survey of all patients for analysis of the management of osteoporosis was conducted one year after clinical treatment.


RESULTS
Both groups were comparable according to numbers of patients, age, distribution between the sexes and fracture localisation. The prospective group consisted of 144 patients. 29.9 % of these patients had already sustained a fragility fracture before treatment of the current fracture. In 45.8 % (32.6 % DEXA scans, 11.8 % Q CT, 1.4 % ultrasound) of the patients diagnostics were performed. A diagnosis of osteoporosis was documented in 42.4 % of the patients, and 57.1 % of the patients received specific treatments according to the guidelines. In the control group, 28.9 % of the patients had already sustained a fragility fracture before treatment of the current fracture. In 91.1 % of the patients no diagnostics for concomitant osteoporosis after clinical treatment for the acute fracture were performed within one year after fracture treatment.


CONCLUSIONS
By use of a multifaceted osteoporosis intervention, more patients received diagnostics and therapy according to the guidelines of osteoporosis after fragility fractures. Without appropriate information, more than 60 % of the high-risk-patients did not receive adequate osteoporosis management. Future research should address barriers to appropriate osteoporosis management. Because of the chronic character of the disease and the necessity of a long-term therapy, continuous medical care and information of patients with osteoporosis is necessary to prevent subsequent fractures.
Bahrs
C
C
Klinik für Unfall- und Wiederherstellungschirurgie, Berufsgenossenschaftliche Unfallklinik Tübingen.
Türk
A
A
Eingartner
C
C
Weise
K
K
Rolauffs
B
B
Stuby
F
F
D015502:Absorptiometry, Photon; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D005194:Family Practice; D005260:Female; D005598:Fractures, Spontaneous / Q000175:diagnosis / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000534:rehabilitation*; D010348:Patient Care Team; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D050071:Bone Density Conservation Agents