Fragility fracture systems, Latin America perspective

Abstract

Osteoporosis is a worldwide epidemic, affecting an average of 30% to 50% of those over 50 years of age in Latin America. Resulting from it is another epidemic, that of fragility fractures, which adversely affects morbidity and mortality of this population. Increasing in their incidence, fragility fractures are expected to occur in 1 in 3 women and 1 in 5 men over 50years of age during their lifetimes.Currently, there are diagnostic and management guidelines for fragility fractures in Latin American countries, especially those for hip and spine fractures. In general, in Latin America, the quality indicators and standards for the care of these fractures vary greatly according to the health system, being suboptimal in many situations.The organization of health services is different in the different countries throughout Latin America. Common underlying characteristics, however, include the distinctions that exist in care between public and private medicine and the lack of economic resources directed to public healthcare systems from the national levels.Several important changes have been implemented in recent years, with the collaboration between national organizations and international associations such as the Fragility Fracture Network and the International Osteoporosis Foundation, aimed at improving quality standards in care and rates of morbidity and mortality in patients treated thorough fragility fracture programs. The underregistration in these programs and absence of formal national registries also contribute to a lack of recognition of the size, scope, and severity of the problem.

Characterization and effectiveness of a Fracture Liaison Services program in Colombia

“…This has allowed the development and generation of resources with a view to optimizing the implementation in the country of post-fracture care models. In addition, with the support of the Colombian Association of Osteoporosis and Mineral Metabolism, the training of health professionals at the national level has continued [ 36 , 37 ]. This is how in the last 2 years there has been an increase in the number of institutions, both public and private, that have adopted the framework of good practices of the IOF, and have been implementing the 11 Key Performance Indicators [ 36 ].…”

Therapeutic advantage of teriparatide in very elderly patients with proximal femoral fractures: a functional and BMD analysis

“…Osteoporotic fractures, notably in the elderly and those with chronic conditions such as diabetes and hypertension, underscore the necessity of tailored prevention strategies, including for high-risk groups like aged individuals and postmenopausal breast cancer patients on aromatase inhibitors [1,2]. Fragility fractures, including hip and vertebral compression fractures, pose significant risks, impairing mobility, independence, and overall quality of life, thus presenting a major public health challenge due to the associated morbidity, mortality, and healthcare costs [3][4][5]. Teriparatide, a parathyroid hormone analog, is recognized for its ability to expedite recovery in older adults with osteoporosis-related fractures by improving bone mineral density (BMD) and reducing pain, which could enhance activities of daily living (ADLs) [6][7][8].…”