[Evaluation of a strategy for the management of accompanying osteoporosis after inpatient treatment of fragility fractures].

AIM: The aim of the present study was to evaluate a strategy for the management of accompanying osteoporosis after inpatient treatment of fragility fractures.

METHOD: A prospective group of patients that was treated for acute fragility fractures between 9/05 and 2/06 was informed about a concomitant osteoporosis according to the national guidelines. Standardised letters with instructions for diagnostics and therapy for osteoporosis were given to patients, members of the family and outpatient care, rehab-clinic and GPs. Between 9/04 and 2/05 a retrospective review of a control group of patients with acute fragility fractures was conducted. This group was not informed about a concomitant osteoporosis. A telephone survey of all patients for analysis of the management of osteoporosis was conducted one year after clinical treatment.

RESULTS: Both groups were comparable according to numbers of patients, age, distribution between the sexes and fracture localisation. The prospective group consisted of 144 patients. 29.9 % of these patients had already sustained a fragility fracture before treatment of the current fracture. In 45.8 % (32.6 % DEXA scans, 11.8 % Q CT, 1.4 % ultrasound) of the patients diagnostics were performed. A diagnosis of osteoporosis was documented in 42.4 % of the patients, and 57.1 % of the patients received specific treatments according to the guidelines. In the control group, 28.9 % of the patients had already sustained a fragility fracture before treatment of the current fracture. In 91.1 % of the patients no diagnostics for concomitant osteoporosis after clinical treatment for the acute fracture were performed within one year after fracture treatment.

CONCLUSIONS: By use of a multifaceted osteoporosis intervention, more patients received diagnostics and therapy according to the guidelines of osteoporosis after fragility fractures. Without appropriate information, more than 60 % of the high-risk-patients did not receive adequate osteoporosis management. Future research should address barriers to appropriate osteoporosis management. Because of the chronic character of the disease and the necessity of a long-term therapy, continuous medical care and information of patients with osteoporosis is necessary to prevent subsequent fractures.