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Value of a coordinated management of osteoporosis via Fracture Liaison Service for the treatment of orthogeriatric patients

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

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.

Materials and 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.

Discussion

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.

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Author information

Authors and Affiliations

  1. Department of General, Trauma and Reconstruction Surgery with integrated Fracture Liaison Service, University of Munich, Munich, Germany

    D. Schray, C. Neuerburg, J. Stein, M. Schieker, W. Böcker & C. Kammerlander

  2. Department of Geriatrics, Klinikum Nürnberg, Paracelsus Private Medical University, Nuremberg, Germany

    M. Gosch

Authors
  1. D. Schray
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  2. C. Neuerburg
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  3. J. Stein
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  4. M. Gosch
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  5. M. Schieker
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  6. W. Böcker
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  7. C. Kammerlander
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Corresponding author

Correspondence to D. Schray.

Ethics declarations

All research on human subjects presented in this paper was conducted in accordance with the ethical research standards prescribed by the responsible national/institutional committee on human experimentation and with the WMA Declaration of Helsinki as of its 7th revision in 2013. Informed consent was obtained from all human subjects participating in the study. The ethical committee of Ludwig-Maximilian-University of Munich approved this study registered under AZ 351-14.

Conflict of interest

Deborah Schray, Carl Neuerburg, Julia Stein, Markus Gosch, Matthias Schieker, Wolfgang Böcker and Christian Kammerlander declare that they have no conflict of interest.

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Schray, D., Neuerburg, C., Stein, J. et al. Value of a coordinated management of osteoporosis via Fracture Liaison Service for the treatment of orthogeriatric patients. Eur J Trauma Emerg Surg 42, 559–564 (2016). https://doi.org/10.1007/s00068-016-0710-5

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  • DOI: https://doi.org/10.1007/s00068-016-0710-5

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