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J Bone Miner Metab. 2019 Oct 3. doi: 10.1007/s00774-019-01047-3. [Epub ahead of print]

Ten years change in post-fracture care for hip fracture patients.

Author information

1
Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
2
Department of Orthopaedic Surgery, Kushiro City General Hospital, Kushiro, Hokkaido, Japan.
3
Department of Orthopaedic Surgery, Iwamizawa City Hospital, Iwamizawa, Hokkaido, Japan.
4
Department of Orthopaedic Surgery, Hakodate General Central Hospital, Hakodate, Hokkaido, Japan.
5
Department of Orthopaedic Surgery, Ebetsu City Hospital, Ebetsu, Hokkaido, Japan.
6
Department of Orthopaedic Surgery, Hokushokai Hospital, Iwamizawa, Hokkaido, Japan.
7
Department of Orthopaedic Surgery, Kushiro Rosai Hospital, Kushiro, Hokkaido, Japan.
8
Department of Orthopaedic Surgery, Obihiro Kosei Hospital, Obihiro, Hokkaido, Japan.
9
Department of Orthopaedic Surgery, Otaru City Hospital, Otaru, Hokkaido, Japan.
10
Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan. simitom@wg8.so-net.ne.jp.

Abstract

INTRODUCTION:

This multicenter, retrospective study aimed to clarify the changes in postoperative care provided by orthopaedic surgeons after hip fractures and clarify the incidence of secondary fractures requiring surgery.

MATERIALS AND METHODS:

Subjects were patients with hip fracture treated surgically in seven hospitals during the 10-year period from January 2008 to December 2017. Data on patient demographics, comorbidities, preoperative and postoperative osteoporosis treatments, and secondary fractures were collected from the medical records.

RESULTS:

In total, 4764 new hip fractures in 982 men and 3782 women (mean age: 81.3 ± 10.0 years) were identified. Approximately 10% of patients had a history of osteoporosis drug treatment and 35% of patients received postoperative drug treatment. The proportion of patients receiving postoperative drug therapy increased by approximately 10% between 2009 and 2010, 10% between 2010 and 2011, and 10% between 2011 and 2013. Although the rate of secondary fractures during the entire period and within 3 years decreased from 2011, the rate of secondary fracture within 1 year remained at around 2% every year.

CONCLUSIONS:

The approval of new osteoporosis drugs and the establishment of osteoporosis liaison services have had a positive effect on the use of postoperative drug therapy in the orthopedic field. Our finding that the rate of secondary fracture within 1 year of the initial fracture remained around 2% every year, despite improvements in postoperative drug therapy, suggests that both rehabilitation for preventing falls and early postoperative drug therapy are essential to prevent secondary fractures.

KEYWORDS:

Anti-osteoporosis therapy; Hip fracture; Osteoporosis liaison service; Secondary fracture

PMID:
31583538
DOI:
10.1007/s00774-019-01047-3

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