scholarly journals Fragility Fracture Care and Orthogeriatric Comanagement

2016 ◽  
Vol 2016 ◽  
pp. 1-1
Author(s):  
Christian Kammerlander ◽  
Hitendra K. Doshi ◽  
Wolfgang Böcker ◽  
Markus Gosch
Keyword(s):  
Fragility Fracture ◽  
Fracture Care ◽  
Orthogeriatric Comanagement

scholarly journals Challenges and strategies in management of osteoporosis and fragility fracture care during COVID-19 pandemic

2020 ◽  
Vol 21 ◽  
pp. 287-290 ◽  
Author(s):  
Gaurav K. Upadhyaya ◽  
Karthikeyan Iyengar ◽  
Vijay K. Jain ◽  
Raju Vaishya
Keyword(s):  
Fragility Fracture ◽  
Fracture Care ◽  
Challenges And Strategies

48 Systematic Approaches to Fragility Fracture Care and Prevention: A Global Perspective

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Paul Mitchell
Keyword(s):  
Fracture Risk ◽  
Fragility Fracture ◽  
Fragility Fractures ◽  
The United States ◽  
Global Perspective ◽  
Asia Pacific ◽  
Medical Attention ◽  
Care Gap ◽  
Fracture Care ◽  
Fracture Liaison

Abstract Fracture begets fracture. Since the 1980s, we have known that approximately half of individuals who sustain a hip fracture break another bone in the months or years before breaking their hip. More recently, investigators in Australia, the United Kingdom and the United States have reported similar findings. Meta-analyses have demonstrated that a prior fracture at any site is associated with a doubling of future fracture risk. Individuals who sustain fragility fractures usually present to healthcare services to seek medical attention and, as such, represent an obvious group to target for osteoporosis assessment and falls prevention. However, a persistent and pervasive care gap is evident in the secondary prevention of fragility fractures throughout the world. The care gap is well documented in countries in Asia-Pacific. A Fracture Liaison Service (FLS) is a system to ensure fracture risk assessment, and treatment where appropriate, is delivered to all patients with fragility fractures. A FLS is usually comprised of a dedicated case worker, often a clinical nurse specialist, who works to pre-agreed protocols to case-find and assess fracture patients. While FLS are usually based in hospital, some primary care based FLS have been developed. A FLS requires support from a medically qualified practitioner. The FLS model of care has been endorsed and advocated for by governments, healthcare professional organisations and national osteoporosis societies, and national alliances comprised of these and other groups. This presentation will provide a global perspective on implementation of FLS as a central component of a broader systematic approach to fragility fracture care and prevention. References Fracture Liaison Services (FLS) Toolbox for Asia Pacific. Asia Pacific Bone Academy. 2017.

scholarly journals 65 Fragility Fracture Network (FFN) Malaysia - A Call to Action for Better Outcome in Malaysia

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Hui Min Khor ◽  
Joon Kiong Lee ◽  
Alan Swee Hock Ch'ng ◽  
Hong Khoh ◽  
Lawrence Lee ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Fragility Fracture ◽  
Care Pathway ◽  
Fragility Fractures ◽  
Fracture Network ◽  
Asia Pacific ◽  
Secondary Fracture ◽  
Fracture Care ◽  
Rate Of Increase

Abstract Introduction The incidences of hip fractures are increasing worldwide and over 50% of all hip fractures are projected to occur in Asia. Malaysia is predicted to have the highest rate of increase in numbers of hip fracture in Asia Pacific by 2050. Despite the health and economic burden associated with fragility fractures, there is limited systematic guidance or nationwide interventions set up to address this foreseeable tsunami in Malaysia. This has called for the formation of a national Fragility Fracture Network to bring together experts from different disciplines nationally to drive policy change and improve quality of care in patients with fragility fracture. Method The Asia Pacific Regional Fragility Fracture Summit held in Singapore in May 2018 brought together representatives of regional societies from geriatrics, orthopedic, osteoporosis and rehabilitation to share key challenges in providing optimal fragility fracture care. Three clinicians from Malaysia representing three different societies in Asia Pacific who attended the summit initiated the idea of forming a national multidisciplinary network to focus on improving acute hip fracture care, post-acute care rehabilitation and secondary fracture prevention. Results After the first meeting held in June 2018 with only 4 members in Kuala Lumpur, the network has expanded to include members from 7 different states in Malaysia. This has led to the formation of the Fragility Fracture Network (FFN) Malaysia in August 2018. The key goals of the network include the development of clinical hip fracture care pathway, initiating national hip fracture registry and fracture liaison service. Conclusion FFN Malaysia serves as a platform to unite healthcare providers and policy makers in prioritizing and having co-ownership in improving fragility fracture care in the country.

scholarly journals Quality Improvement Initiatives in Fragility Fracture Care and Prevention

2019 ◽  
Vol 17 (6) ◽  
pp. 510-520 ◽  
Author(s):  
Paul J. Mitchell ◽  
Cyrus Cooper ◽  
Masaki Fujita ◽  
Philippe Halbout ◽  
Kristina Åkesson ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Fragility Fracture ◽  
Fracture Care

Systematic approaches to fragility fracture prevention

2014 ◽  
Vol 23 (01) ◽  
pp. 39-44
Author(s):  
D. B. Lee ◽  
P. J. Mitchell
Keyword(s):  
Fragility Fracture ◽  
National Policy ◽  
Fragility Fractures ◽  
Fracture Prevention ◽  
The United States ◽  
Fracture Liaison Service ◽  
Reimbursement Mechanisms ◽  
Future Fracture ◽  
National Coalition ◽  
Fracture Liaison

SummaryIndividuals who have suffered fractures caused by osteoporosis – also known as fragility fractures – are the most readily identifiable group at high risk of suffering future fractures. Globally, the majority of these individuals do not receive the secondary preventive care that they need. The Fracture Liaison Service model (FLS) has been developed to ensure that fragility fracture patients are reliably identified, investigated for future fracture and falls risk, and initiated on treatment in accordance with national clinical guidelines. FLS have been successfully established in Asia, Europe, Latin America, North America and Oceania, and their widespread implementation is endorsed by leading national and international osteoporosis organisations. Multi-sector coalitions have expedited inclusion of FLS into national policy and reimbursement mechanisms. The largest national coalition, the National Bone Health Alliance (NBHA) in the United States, provides an exemplar of achieving participation and consensus across sectors. Initiatives developed by NBHA could serve to inform activities of new and emerging coalitions in other countries.

The Rationale of Operative Fracture Care

1996 ◽  
Author(s):  
Joseph Schatzker ◽  
Marvin Tile
Keyword(s):  
Fracture Care

Osteoporose und Frakturrisiko beim älteren Sportler: Aktuelle Guidelines

2014 ◽  
Vol 62 (4) ◽  
Keyword(s):  
Fragility Fracture ◽  
Elderly Person ◽  
Vitamin D Supplementation ◽  
Risk Scores ◽  
Human Beings ◽  
Off Label Use ◽  
Risk Of Falling ◽  
Treatment Of Osteoporosis ◽  
Pharmacological Prevention ◽  
Age Related

A Fragility Fracture is nowadays looked upon to be the most important clinical symptom of osteoporosis. The sportive elderly have a limited risk to suffer from this event. Mechanical loading of the skeleton which is associated with most sporty activities prevents age related bone loss. Furthermore, if a fracture happens as a result from sporty activity, the criterion of a fragility fracture is usually not met. Elderly sportsmen who want to be reassured or who are going to restart activity after a break can be offered a fracture risk calculation by means of FRAX. Correct interpretation of the risk scores needs knowledge of the boundary conditions the algorithm is based on. In contrast a DEXA scan is rarely indicated in this situation. Vitamin D Supplementation can generally be adviced for every elderly person in our region, especially for the sportive ones. Sufficient intake of calcium and protein shall be achieved by a healthy diet. Despite of the risk of falling that is usually associated with any sportive activity it may be summarized, that there is less fractures in active people. As long as human beings stay mobile and active, pharmacological prevention or treatment of osteoporosis is rarely indicated. An exeption from this is osteoanabolic treatment of insufficiency and stress fractures. This shall be mentioned here even though it is an “off-label” use of the drugs.

scholarly journals Prior Admissions as a Risk Factor for Readmission in Patients Surgically Treated for Femur Fractures: Implications for a Potential Hip Fracture Bundle

2021 ◽  
Vol 12 ◽  
pp. 215145932199616
Author(s):  
Robert Erlichman ◽  
Nicholas Kolodychuk ◽  
Joseph N. Gabra ◽  
Harshitha Dudipala ◽  
Brook Maxhimer ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Hip Fracture ◽  
Logistic Regression Analysis ◽  
Hip Fractures ◽  
Surgical Procedure ◽  
Hospital Admissions ◽  
Fracture Care ◽  
Increased Risk ◽  
Payment Models

Introduction: Hip fractures are a significant economic burden to our healthcare system. As there have been efforts made to create an alternative payment model for hip fracture care, it will be imperative to risk-stratify reimbursement for these medically comorbid patients. We hypothesized that patients readmitted to the hospital within 90 days would be more likely to have a recent previous hospital admission, prior to their injury. Patients with a recent prior admission could therefore be considered higher risk for readmission and increased cost. Methods: A retrospective chart review identified 598 patients who underwent surgical fixation of a hip or femur fracture. Data on readmissions within 90 days of surgical procedure and previous admissions in the year prior to injury resulting in surgical procedure were collected. Logistic regression analysis was used to determine if recent prior admission had increased risk of 90-day readmission. A subgroup analysis of geriatric hip fractures and of readmitted patients were also performed. Results: Having a prior admission within one year was significantly associated (p < 0.0001) for 90-day readmission. Specifically, logistic regression analysis revealed that a prior admission was significantly associated with 90-day readmission with an odds ratio of 7.2 (95% CI: 4.8-10.9). Discussion: This patient population has a high rate of prior hospital admissions, and these prior admissions were predictive of 90-day readmission. Alternative payment models that include penalties for readmissions or fail to apply robust risk stratification may unjustly penalize hospital systems which care for more medically complex patients. Conclusions: Hip fracture patients with a recent prior admission to the hospital are at an increased risk for 90-day readmission. This information should be considered as alternative payment models are developed for hip fracture care.

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