Secondary Fracture Prevention

Introduction: A need exists for improved care pathways for patients experiencing low-energy pelvic ring fractures. A review of the current literature was performed to understand the typical patient care and post-acute rehabilitation pathway within the US healthcare system. We also sought to summarize reported clinical outcomes worldwide. Significance: Low-energy pelvic ring fracture patients usually do not qualify for inpatient admission, yet they often require post-acute rehabilitative care. The Center for Medicare and Medicaid Services’ (CMS) 3-day rule is a barrier to obtaining financial coverage of this rehabilitative care. Results: Direct admission of some patients to post-acute care facilities has shown promise with decreased cost, improved patient outcomes, and increased patient satisfaction. Secondary fracture prevention programs may also improve outcomes for this patient population. Conclusions: Post-acute care innovation and secondary fracture prevention should be prioritized in the low-energy pelvic fragility fracture patient population. To demonstrate the effect and feasibility of these improved care pathways, further studies are necessary.

PAO22 REFILL ADHERENCE IN OSTEOPOROTIC WOMEN WITH PRIMARY AND SECONDARY FRACTURE PREVENTION

Value in Health ◽

10.1016/s1098-3015(10)60974-6 ◽

2002 ◽

Vol 5 (3) ◽

pp. 185-186

Author(s):

CD Beilfuss ◽

MJ Wall ◽

JS Graff ◽

CR McBurney ◽

AM Fendrick

Keyword(s):

Fracture Prevention ◽

Secondary Fracture ◽

Secondary Fracture Prevention ◽

Refill Adherence

Early benefits of a secondary fracture prevention programme

Hip International ◽

10.1177/11207000211027476 ◽

2021 ◽

pp. 112070002110274

Author(s):

Gershon Zinger ◽

Noa Sylvetsky ◽

Yedin Levy ◽

Kobi Steinberg ◽

Alexander Bregman ◽

...

Keyword(s):

Hip Fracture ◽

Fracture Risk ◽

Fragility Fracture ◽

Intervention Group ◽

Fracture Prevention ◽

Intervention Programme ◽

Secondary Fracture ◽

Secondary Fracture Prevention ◽

Randomised Study ◽

Dexa Scan

Introduction: The most successful programme for secondary fracture prevention is the FLS (fracture liaison service) model. Our orthopaedic department carried out a prospective randomised study to measure the effectiveness of a 4-step intervention programme. The findings in this study reveal important additional clinical benefits to having an orthopaedic-based FLS programme and evaluates the usefulness of fracture risk tools. Methods: We carried out a prospective study to evaluate patients with a fragility fracture of the hip. There were 2 groups, intervention and control (each 100 patients). Of these, 20 were either removed from the study or dropped out, leaving 180 for analysis. In addition to routine preoperative blood tests, albumin and thyroid function levels were obtained and PTH (parathyroid hormone) levels when indicated. The intervention group (83 patients) had a dual-energy x-ray absorptiometry (DEXA) scan performed and fracture risk (FRAX) was calculated. Results: 12 patients (6.7%) had blood results which showed a potentially treatable cause for osteoporosis and 36 (20%) had blood results that changed their medical care. FRAX scores (180 patients) showed that the major osteoporotic fracture score correctly predicted the hip fracture in only 49%. The hip fracture score correctly predicted the hip fracture in 83%. DEXA scores (65 patients) showed osteoporosis in only 46% of hips and in only 26% of spines. An abnormal FRAX score or DEXA scan would have predicted a fragility fracture 93% of the time. Conclusions: In addition to reducing secondary fractures, FLS programmes can provide fundamental benefits to the health of the patient. The intervention programme in this study identified patients with underlying treatable causes, correctable clinical conditions and patients with an unusually low bone density. When used together, FRAX and DEXA are more sensitive predictors for hip fracture risk than either are individually. Trial registry: 201497CTIL ( https://clinicaltrials.gov/ct2/show/NCT02239523 )

Osteoporosis Management following Vertebral Fracture Remains Inadequate When Secondary Fracture Prevention Programs Are Not Implemented

The Spine Journal ◽

10.1016/j.spinee.2017.07.111 ◽

2017 ◽

Vol 17 (10) ◽

pp. S123 ◽

Cited By ~ 1

Author(s):

David W. Barton ◽

Caleb J. Behrend ◽

Jonathan J. Carmouche

Keyword(s):

Vertebral Fracture ◽

Prevention Programs ◽

Fracture Prevention ◽

Secondary Fracture ◽

Secondary Fracture Prevention ◽

Osteoporosis Management

Introducing the American Society for Bone and Mineral Research multistakeholder group secondary fracture prevention recommendations

Journal of the American Association of Nurse Practitioners ◽

10.1097/jxx.0000000000000616 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Ivy M. Alexander ◽

Linda Bowka ◽

Freda Hannafon ◽

Anne Lake ◽

Kathy Williams ◽

...

Keyword(s):

Fracture Prevention ◽

Mineral Research ◽

Secondary Fracture ◽

Secondary Fracture Prevention ◽

American Society

Inadequate management for secondary fracture prevention in patients with distal radius fracture by trauma surgeons

Osteoporosis International ◽

10.1007/s00198-015-3103-4 ◽

2015 ◽

Vol 26 (7) ◽

pp. 1959-1963 ◽

Cited By ~ 19

Author(s):

T. Baba ◽

H. Hagino ◽

H. Nonomiya ◽

T. Ikuta ◽

E. Shoda ◽

...

Keyword(s):

Distal Radius Fracture ◽

Distal Radius ◽

Fracture Prevention ◽

Radius Fracture ◽

Secondary Fracture ◽

Secondary Fracture Prevention ◽

Trauma Surgeons

Therapeutic Approaches to Secondary Fracture Prevention in High Risk Populations

American Journal of Therapeutics ◽

10.1097/mjt.0000000000000660 ◽

2018 ◽

Vol 25 (1) ◽

pp. e104-e114

Author(s):

Huei-Wen Lim ◽

Melissa Chamblain ◽

Benny Wong ◽

Siddharth Raghavan

Keyword(s):

High Risk ◽

Fracture Prevention ◽

Therapeutic Approaches ◽

Secondary Fracture ◽

Secondary Fracture Prevention ◽

High Risk Populations