title: Value of a coordinated management of osteoporosis via Fracture Liaison Service for the treatment of orthogeriatric patients.
abstract: BACKGROUND
  The 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.
  
  
  METHODS
  According 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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  Due 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.
authors.affiliation: Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany. Deborah.Schray@med.uni-muenchen.de.
authors.forename: D
authors.initials: D
authors.lastname: Schray
authors.affiliation: Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Neuerburg
authors.affiliation: Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Stein
authors.affiliation: Department of Geriatrics, Klinikum Nürnberg, Paracelsus Private Medical University, Nuremberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Gosch
authors.affiliation: Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Schieker
authors.affiliation: Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Böcker
authors.affiliation: Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Kammerlander
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D003695:Delivery of Health Care / Q000458:organization & administration*; D019587:Dietary Supplements; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D058866:Osteoporotic Fractures / Q000517:prevention & control; D018802:Patient-Centered Care; D017410:Practice Guidelines as Topic; D055502:Secondary Prevention / Q000458:organization & administration*
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates
keywords: Fracture Liaision Service; Fragility Fracture Nurse; Frailty; Hip fracture; Orthogeriatric patients; Osteoporosis