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عنوان ترانسليتريتد: Dresdener Netzwerk Osteoporose.

المؤلفون: Fülling T; Department of Trauma, Reconstructive and Hand Surgery, Dresden Municipal Hospital., Bula P; Department of Trauma and Reconstructive Surgery, Orthopaedic, Plastic, Aesthetic and Hand Surgery, Gutersloh Municipal Hospital., Defèr A; General Medicine, Private Practice, Dresden., Bonnaire FA; Department of Trauma, Reconstructive and Hand Surgery, Dresden Municipal Hospital.

المصدر: Zeitschrift fur Orthopadie und Unfallchirurgie [Z Orthop Unfall] 2021 Aug; Vol. 159 (4), pp. 438-446. Date of Electronic Publication: 2020 May 19.

نوع المنشور: Journal Article; Randomized Controlled Trial

بيانات الدورية: Publisher: Georg Thieme Verlag Country of Publication: Germany NLM ID: 101308227 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1864-6743 (Electronic) Linking ISSN: 18646697 NLM ISO Abbreviation: Z Orthop Unfall Subsets: MEDLINE

مواضيع طبية MeSH: Bone Density Conservation Agents* , Osteoporosis*/epidemiology , Osteoporotic Fractures*/epidemiology, Delivery of Health Care ; Humans ; Prospective Studies ; Secondary Prevention

مستخلص: Purpose: On a global scale the main focus of traumatological therapy lies in the treatment of unintentional injuries or victims of violence. People of all ages and through all economic groups can be affected. Due to demographic change in Western industrial countries, however, this focus increasingly shifts towards fragility fractures. In Europe osteoporosis is the most common bone disease in advanced age. Secondary prevention programs like the Fracture Liaison Service (FLS) are becoming increasingly prevalent, especially in Anglo-American health care systems. In German orthopedic and trauma wards and hospitals, however, the FLS is still relatively uncommon. This article will examine the question whether secondary prevention programs like FLS need to be established in the German health care system. This study aims at finding out, whether in the area of a medium sized German city there is a difference regarding the initiation of osteoporosis diagnosis and therapy between the regular aftercare by the general practitioner or the orthopedic surgeon and the aftercare by a specialist trained in osteology (Osteologe).
Materials and Methods: For the open, randomized prospective study 70 patients with low energy fractures were recruited, who were older than 60 years and have been treated in our department.
Results: 58 out of 70 patients have completed the study, which amounts to a follow-up of 82.9%. Limited mobility and a high degree of organizational effort were the main reasons for early termination of the study. While in the group with regular aftercare, only 2 out of 29 patients received a specific osteoporosis treatment, in group who were directly transferred to a specialist trained in osteology 17 out of 29 patients received specific treatment. After re-evaluation of group with regular aftercare in 21 out of 29 cases a specific osteoporosis treatment was recommended.
Conclusions: It could be established that there is a significant diagnosis and treatment gap regarding the aftercare of patients with fractures caused by osteoporosis between general practitioners or orthopedic surgeons on the one hand and the specialists trained in osteology on the other hand. To improve the aftercare of fracture patients, cross sectoral networks with a background in geriatrics and orthopedic-trauma surgery like a FLS need to be established in the German healthcare system.
Competing Interests: The authors declare that they have no conflict of interest./Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.
(Thieme. All rights reserved.)

المؤلفون: Strassberger C; Department of Trauma, Reconstructive and Hand-Surgery, Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Germany. Strassberger-Ca@khdf.de, Unger L, Weber AT, Defer A, Bonnaire FA

المصدر: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2010 Jan; Vol. 130 (1), pp. 103-9. Date of Electronic Publication: 2009 Nov 03.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Springer Verlag Country of Publication: Germany NLM ID: 9011043 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1434-3916 (Electronic) Linking ISSN: 09368051 NLM ISO Abbreviation: Arch Orthop Trauma Surg Subsets: MEDLINE

مواضيع طبية MeSH: Algorithms* , Delivery of Health Care, Integrated*, Fractures, Bone/*etiology , Fractures, Bone/*therapy , Osteoporosis/*complications, Absorptiometry, Photon ; Aged ; Bone Density ; Female ; Germany ; Humans ; Male ; Practice Guidelines as Topic

مستخلص: Introduction: Multidisciplinary medical management of osteoporosis and osteoporosis-related fractures is still an important treatment issue today. In view of ethiopathology of osteoporosis and the future demographic development an increasing socioeconomic burden has to be estimated. A prerequisite for an effective secondary prophylaxis of osteoporotic fractures is the implementation of a treatment network, with inclusion of all partners involved in patient's care. Therefore, special attention should be paid to formation and establishment of centres with multidisciplinary and integrated treatment concepts. This paper outlines the concept of a clinical centre for diagnosis and therapy of osteoporosis established 4 years ago. Furthermore, a concept of integrated care of osteoporosis-related fractures is introduced and the obtained data of a 2-year follow-up analysis will be presented.
Methods: The establishment of an osteoporosis centre at a university teaching hospital as well as certification according to the Dachverband Osteologie (DVO) guidelines were necessary. Recruitment of contract partners on both sides, health insurances and outpatient general practitioners as well as specialist doctors, was also essential. The implementation of an osteoporosis coordinator was a step to put the treatment concept into practice.
Results and Discussion: Based on the recommendations of DVO guidelines, all diagnostic and therapeutic requirements of osteoporosis can be met by the team of consultant specialists at a clinical osteoporosis centre. In the described treatment concept of integrated care, 44 patients suffering of osteoporosis with a consecutive fracture could be included. Mean age was 77. Inclusion criteria were spinal fractures (61%), proximal femoral fractures (27%) and peripheral fractures (12%). Fifty percent of patients included into the contract had not received previous osteoporosis medication. Sixty-eight patients who met the inclusion criteria could not be included due to the lack of compliance (42%), patients' disapproval (34%) or incomplete treatment and documentation algorithm (24%). Special attention should focus on the completion of standardised diagnosis and documentation. The high amount of time and personnel required has proven the importance of the introduction of an osteoporosis coordinator to be essential.