Hip fracture prevention

2003 ◽  
Vol 114 (3) ◽  
pp. 22-32 ◽  
Author(s):  
Justus J. Fiechtner
Keyword(s):  
Hip Fracture ◽  
Fracture Prevention

scholarly journals Early benefits of a secondary fracture prevention programme

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 )

Meta-analysis for the efficacy of bisphosphonates on hip fracture prevention

2020 ◽  
Vol 38 (5) ◽  
pp. 678-686
Author(s):  
Takayuki Tsuda ◽  
Yoshichika Hashimoto ◽  
Yasunori Okamoto ◽  
Wataru Ando ◽  
Kosuke Ebina
Keyword(s):  
Hip Fracture ◽  
Meta Analysis ◽  
Fracture Prevention

scholarly journals Biomechanical Evaluations of Hip Fracture Prevention by Hip Protector

2004 ◽  
Vol 70 (697) ◽  
pp. 1193-1200 ◽  
Author(s):  
Eiichi TANAKA ◽  
Sota YAMAMOTO ◽  
Shigenobu OZEKI ◽  
Koji MIZUNO ◽  
Atsushi HARADA ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Fracture Prevention ◽  
Hip Protector

scholarly journals Failure in the application of fragility fracture prevention guidelines

2014 ◽  
Vol 96 (5) ◽  
pp. 381-385 ◽  
Author(s):  
MH Elvey ◽  
H Pugh ◽  
G Schaller ◽  
G Dhotar ◽  
B Patel ◽  
...  
Keyword(s):  
Hip Fracture ◽  
High Risk ◽  
Fragility Fracture ◽  
Fragility Fractures ◽  
Fracture Prevention ◽  
Consecutive Series ◽  
National Guidelines ◽  
Fracture Population ◽  
The Mean ◽  
The Uk

Introduction The cost of fragility fractures to the UK economy is predicted to reach £2.2 billion by 2025. We studied our hip fracture population to establish whether national guidelines on fragility fracture prevention were being followed, and whether high risk patients were identified and treated by local care services. Methods Data on a consecutive series of trauma hip fracture admissions were collected prospectively over 14 months. National Institute for Health and Care Excellence (NICE) and National Osteoporosis Guideline Group (NOGG) recommendations and FRAX® risk calculations were applied to patients prior to their admission with a new hip fracture. Results Overall, 94 patients were assessed against national guidelines. The mean population age was 77 years. Almost a quarter (22%) of patients had suffered a previous fragility fracture. The mean FRAX® ten-year probability of hip fracture was 7%. According to guidelines, 45% of the study population required treatment, 35% fulfilled criteria for investigation and reassessment, and 20% needed no further management. In practice, 27% received treatment, 4% had undergone dual energy x-ray absorptiometry and were untreated, and 69% had not been investigated and were untreated. In patients meeting intervention thresholds, only 33% of those who required treatment were receiving treatment in practice. Conclusions In conjunction with NICE and NOGG recommendations, FRAX® was able to identify 80% of our fracture population as intermediate or high risk on the day of fracture. Correct management was evident in a third of cases with a pattern of inferior guideline compliance seen in a London population. There remains a lack of clarity over the duty of care in fragility fracture prevention.

scholarly journals Effects of a Social Cognitive Theory-Based Hip Fracture Prevention Web Site for Older Adults

2010 ◽  
Vol 28 (6) ◽  
pp. 371-379 ◽  
Author(s):  
EUN-SHIM NAHM ◽  
BAUSELL BARKER ◽  
BARBARA RESNICK ◽  
BARBARA COVINGTON ◽  
JAY MAGAZINER ◽  
...  
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Social Cognitive Theory ◽  
Web Site ◽  
Social Cognitive ◽  
Cognitive Theory ◽  
Fracture Prevention

scholarly journals Arthritis Increases the Risk for Fractures — Results from the Women’s Health Initiative

2011 ◽  
Vol 38 (8) ◽  
pp. 1680-1688 ◽  
Author(s):  
NICOLE C. WRIGHT ◽  
BRIAN T. WALITT ◽  
CHARLES B. EATON ◽  
ZHAO CHEN ◽  
Keyword(s):  
Hip Fracture ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Spinal Fractures ◽  
Fracture Prevention ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Hazards Model ◽  
Increased Risk ◽  
Clinical Fractures

Objective.To examine the relationship between arthritis and fracture.Methods.Women were classified into 3 self-reported groups at baseline: no arthritis (n = 83,295), osteoarthritis (OA; n = 63,402), and rheumatoid arthritis (RA; n = 960). Incident fractures were self-reported throughout followup. Age-adjusted fracture rates by arthritis category were generated, and the Cox proportional hazards model was used to test the association between arthritis and fracture.Results.After an average of 7.80 years, 24,137 total fractures were reported including 2559 self-reported clinical spinal fractures and 1698 adjudicated hip fractures. For each fracture type, age-adjusted fracture rates were highest in the RA group and lowest in the nonarthritic group. After adjustment for several covariates, report of arthritis was associated with increased risk for spine, hip, and any clinical fractures. Compared to the nonarthritis group, the risk of sustaining any clinical fracture in the OA group was HR 1.09 (95% CI 1.05, 1.13; p < 0.001) and HR 1.49 (95% CI 1.26, 1.75; p < 0.001) in the RA group. The risk of sustaining a hip fracture was not statistically increased in the OA group (HR 1.11; 95% CI 0.98, 1.25; p = 0.122) compared to the nonarthritis group; however, the risk of hip fracture increased significantly (HR 3.03; 95% CI 2.03, 4.51; p < 0.001) in the RA group compared to the nonarthritis group.Conclusion.The increase in fracture risk confirms the importance of fracture prevention in patients with RA and OA.

scholarly journals Increased Geriatric Treatment Frequency Improves Mobility and Secondary Fracture Prevention in Older Adult Hip Fracture Patients—An Observational Cohort Study of 23,828 Patients from the Registry for Geriatric Trauma (ATR-DGU)

2021 ◽  
Vol 10 (23) ◽  
pp. 5489
Author(s):  
Johannes Gleich ◽  
Evi Fleischhacker ◽  
Katherine Rascher ◽  
Thomas Friess ◽  
Christian Kammerlander ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Older Adult ◽  
Osteoporosis Treatment ◽  
Fracture Prevention ◽  
Observational Cohort Study ◽  
Geriatric Trauma ◽  
Secondary Fracture ◽  
Secondary Fracture Prevention ◽  
Observational Cohort

Interdisciplinary orthogeriatric care of older adult hip fracture patients is of growing importance due to an ageing population, yet there is ongoing disagreement about the most effective model of care. This study aimed to compare different forms of orthogeriatric treatment, with focus on their impact on postoperative mobilization, mobility and secondary fracture prevention. In this observational cohort study, patients aged 70 years and older with a proximal femur fracture requiring surgery, were included from 1 January 2016 to 31 December 2019. Data were recorded from hospital stay to 120-day follow-up in the Registry for Geriatric Trauma (ATR-DGU), a specific designed registry for older adult hip fracture patients. Of 23,828 included patients from 95 different hospitals, 72% were female, median age was 85 (IQR 80–89) years. Increased involvement of geriatricians had a significant impact on mobilization on the first day (OR 1.1, CI 1.1–1.2) and mobility seven days after surgery (OR 1.1, CI 1.1–1.2), initiation of an osteoporosis treatment during in-hospital stay (OR 2.5, CI 2.4–2.7) and of an early complex geriatric rehabilitation treatment (OR 1.3, CI 1.2–1.4). These findings were persistent after 120 days of follow-up. Interdisciplinary treatment of orthogeriatric patients is beneficial and especially during in-patient stay increased involvement of geriatricians is decisive for early mobilization, mobility and initiation of osteoporosis treatment. Standardized treatment pathways in certified geriatric trauma departments with structured data collection in specific registries improve outcome monitoring and interpretation.

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