Logo Logo
Help
Contact
Switch Language to German

Neuerburg, Carl; Mittlmeier, Lena; Schmidmaier, Ralf; Kammerlander, Christian; Böcker, Wolfgang; Mutschler, Wolf and Stumpf, Ulla (2017): Investigation and management of osteoporosis in aged trauma patients: a treatment algorithm adapted to the German guidelines for osteoporosis. In: Journal of Orthopaedic Surgery and Research 12:86 [PDF, 1MB]

[thumbnail of Neuerburg_Investigation_and_management_of_osteoporosis_in_aged_trauma_patients_a_treatment_algorithm_adapted_to_the_German_guidelines_for_osteoporosis.pdf]
Preview
Download (1MB)

Abstract

Background: Osteoporosis-associated fractures are of increasing importance in trauma surgery. Systematic diagnostics and treatment of osteoporosis during a hospital stay, however, remain inadequate. Therefore, a specific algorithm for diagnosing and treating osteoporosis in trauma surgery patients was developed based on the DVO (German Osteology Society) guideline for osteoporosis from 2014. Methods: In a first step, the individuals' age and risk profile for osteoporosis is identified considering specific fractures indicating osteoporosis and risk factors assessed by a specific questionnaire. In addition, physical activity, risk of falls, dietary habits and the individuals' medication are considered. Basic osteoporosis laboratory tests, a bone densitometry by dual-energy X-ray absorptiometry (DXA) and, if needed, X-rays of the spine are carried out to identify prevalent vertebral body fractures. Results: Based on the treatment algorithm adapted to the new guidelines for osteoporosis in the majority of proximal femoral fractures, treatment of osteoporosis could already be indicated without prior DXA. In case of preexisting glucocorticoid therapy, a history of previous fractures or other risk factors according to the risk questionnaire, the threshold of treatment has to be adjusted given the table of T-scores. Conclusions: The treatment algorithm for diagnosing and treating osteoporosis in in-patient trauma surgery patients can help identify high-risk patients systematically and efficiently. As a result, osteoporosis-associated fractures or failure of osteosynthesis could be reduced, yet a prospective validation of the algorithm has to be completed.

Actions (login required)

View Item View Item