BACKGROUND: Osteoporosis and the resulting fragility fractures, particularly femoral fractures, place significant socioeconomic burdens on the health care system globally. In addition, there is a general lack of awareness of osteoporosis, resulting in underestimation of the associated risks and suboptimal treatment of the disease. The fracture liaison service (FLS) represents an exemplary model of post-fracture care that involves a multidisciplinary approach to the frail patient through the collaboration of multiple specialists. The purpose of this article is to highlight the path undertaken by the Italian Society of Orthopaedics and Traumatology (SIOT) for the purpose of certification of numerous FLS centers throughout Italy.
METHODS: SIOT is proceeding with international FLS accreditation in several Italian Fracture Units (FUs), following the creation of a model that provides specific operational and procedural steps for the management of fragility fractures throughout the country. FUs that decide to join the project and implement this model within their facility are then audited by an ACCREDIA-accredited medical certification body.
RESULTS: The drafted FLS model, thanks to the active involvement of a panel of experts appointed by SIOT, outlines a reference operational model that describes a fluid and articulated process that identifies the procedure of identification, description of diagnostic framing, and subsequent initiation of appropriate secondary prevention programs for fractures of individuals who have presented with a recent fragility fracture of the femur.
CONCLUSIONS: Accreditation of this prevention model will enable many facilities to take advantage of this dedicated diagnostic-therapeutic pathway for the purpose of fracture prevention and reduction of associated health and social costs.
背景:骨质疏松和由此产生的脆性骨折,尤其是股骨骨折,给全球医疗保健系统带来重大的社会经济负担。此外,人们普遍缺乏对骨质疏松症的认识,导致对相关风险的低估和对疾病的次优治疗。骨折联络服务(FLS)代表了骨折后护理的示例性模型,该模型涉及通过多个专家的合作对虚弱患者的多学科方法。本文的目的是强调意大利骨科和创伤学会(SIOT)为整个意大利众多FLS中心的认证而采取的道路。
方法:SIOT正在多个意大利断裂单位(FU)进行国际FLS认证,在创建一个模型之后,该模型为全国各地的脆性裂缝管理提供了具体的操作和程序步骤。决定加入该项目并在其设施内实施该模型的FU然后由ACCREDIA认可的医疗认证机构进行审核。
结果:起草的FLS模型,感谢SIOT任命的专家小组的积极参与,概述了一个参考操作模型,该模型描述了确定识别程序的流体和关节过程,诊断框架的描述,以及随后针对最近出现股骨脆性骨折的个体的骨折启动适当的二级预防计划。
结论:这种预防模式的认可将使许多机构能够利用这种专门的诊断-治疗途径来预防骨折并减少相关的健康和社会成本。