Abstract:
Osteoporosis is a systemic skeletal disease where there is low bone mass and deterioration of bone microarchitecture, leading to an increased risk of a fragility fracture. The aim of this clinical guideline from Fragility Fracture Network Hong Kong SAR, is to provide evidence-based recommendations on the post-acute treatment of the osteoporotic fracture patient that presents for clinical care at the Fracture Liaison Service (FLS). It is now well established that the incidence of a second fracture is especially high after the first 2 years of the initial osteoporotic fracture. Therefore, the recent osteoporotic fracture should be categorized as \"very-high\" re-fracture risk. Due to the significant number of silent vertebral fractures in the elderly population, it is also recommended that vertebral fracture assessment (VFA) should be incorporated into FLS. This would have diagnostic and treatment implications for the osteoporotic fracture patient. The use of a potent anti-osteoporotic agent, and preferably an anabolic followed by an anti-resorptive agent should be considered, as larger improvements in BMD is strongly associated with a reduction in fractures. Managing other risk factors including falls and sarcopenia are imperative during rehabilitation and prevention of another fracture. Although of low incidence, one should remain vigilant of the atypical femoral fracture. The aging population is increasing worldwide, and it is expected that the treatment of osteoporotic fractures will be routine. The recommendations are anticipated to aid in the daily clinical practice for clinicians.
UNASSIGNED: Fragility fractures have become a common encounter in clinical practise in the hospital setting. This article provides recommendations on the post-acute management of fragility fracture patients at the FLS.
摘要:
骨质疏松症是一种全身性骨骼疾病,其中骨量低,骨微结构恶化,导致脆性骨折的风险增加。本临床指南的目的来自香港特别行政区脆性骨折网,为骨质疏松性骨折患者的急性后治疗提供循证建议,为骨折联络服务(FLS)提供临床护理。现在已经确定,在最初的骨质疏松性骨折的前2年之后,第二次骨折的发生率特别高。因此,最近的骨质疏松性骨折应被归类为“非常高”的再骨折风险。由于老年人群中有大量的无声椎体骨折,还建议将椎骨骨折评估(VFA)纳入FLS.这将对骨质疏松性骨折患者具有诊断和治疗意义。使用有效的抗骨质疏松剂,并且优选地,应该考虑合成代谢,然后是抗吸收剂,BMD的较大改善与骨折的减少密切相关。在康复和预防其他骨折期间,必须管理其他风险因素,包括跌倒和肌肉减少症。虽然发病率低,我们应该对不典型的股骨骨折保持警惕。全球老龄化人口正在增加,预计骨质疏松性骨折的治疗将成为常规。这些建议预计将有助于临床医生的日常临床实践。
UNASSIGNED:脆性骨折已成为医院临床实践中常见的问题。本文提供了有关FLS脆性骨折患者急性后管理的建议。