The yawning gap between osteoporosis diagnosis and treatment after a fragility fracture in Mexico

Macías‐Hernández, Salvador Israel; Degollado-Rodríguez, Miriam Macarena; Maldonado-Sánchez, Horacio; León, Andrea Olascoaga-Gómez de; Coronado‐Zarco, Roberto; Nava‐Bringas, Tania Inés; Ramírez-Pérez, Esperanza; Cruz‐Medina, Eva; Espinosa-Morales, Rolando; Morones-Alba, Juan Daniel

doi:10.1007/s11657-021-00926-5

Cited by 5 publications

(8 citation statements)

References 23 publications

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“…Research shows that the rate of treatment with anti-osteoporosis medication after surgical intervention for the first fragility fracture is higher now than 10 years ago [ 5 ]. In various countries, however, there is a large gap between the number of patients who need osteoporosis treatment and the number of patients who actually receive osteoporosis treatment [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of subsequent contralateral proximal femoral fracture: more convenient access is needed to treat osteoporosis

et al. 2023

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Background Patients with proximal femoral fracture (PFF) have high mortality and many complications. Osteoporosis increases the risk of subsequent fractures, leading to subsequent contralateral PFF. This study was performed to analyze the features of individuals with subsequent PFF following surgical therapy of first PFF and to ascertain whether such patients received an examination or treatment of osteoporosis. The reasons for lack of examination or treatment were also analyzed. Methods This retrospective study involved 181 patients with subsequent contralateral PFF who underwent surgical treatment in Xi'an Honghui hospital from September 2012 to October 2021. The patients’ sex, age, hospital day, mechanism of injury, surgical procedure, fracture interval, fracture type, fracture classification, and Singh index of the contralateral hip at the time of the initial and subsequent fractures were recorded. Whether the patients took calcium and vitamin D supplements, used anti-osteoporosis medication, or underwent a dual X-ray absorptiometry (DXA) scan was recorded, as was the start time of each. Patients who had never undergone a DXA scan or received anti-osteoporosis medication took part in a questionnaire. Results The 181 patients in this study comprised 60 (33.1%) men and 121 (66.9%) women. Patients with initial PFF and subsequent contralateral PFF had a median age of 80 years (range 49–96 years) and 82 years (range 52–96 years), respectively. The median fracture interval was 24 (7–36) months. Contralateral fractures occurred at the highest incidence between 3 months and 1 year (28.7%). The Singh index was not significantly different between the two fractures. In 130 (71.8%) patients, the fracture type was the same. No significant difference was found in the fracture type or fracture stability classification. A total of 144 (79.6%) patients had never received a DXA scan or anti-osteoporosis medication. The main reason for not treating osteoporosis further was concern about the safety of drug interactions (67.4%). Conclusions Patients with subsequent contralateral PFF were of advanced age, had a higher proportion of intertrochanteric femoral fractures, had more severe osteoporosis, and had longer hospital stays. The difficulty managing such patients requires multidisciplinary involvement. Most of these patients were not screened or formally treated for osteoporosis. Advanced-age patients with osteoporosis need reasonable treatment and management.

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Section: Introductionmentioning

confidence: 99%

Characteristics of subsequent contralateral proximal femoral fracture: more convenient access is needed to treat osteoporosis

et al. 2023

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“…Following the fractures in those anatomic regions at 1 and 3 years, 144 (17.1%), 71 (8.4%), and 96 (11.4%), respectively, received a pharmacological treatment, 195 (23.2%), 65 (7.7%), and 45 (5.3%) supplementations with vitamin D and calcium, and 16 (1.9%), 16 (1.9%), and 21 (2.5%) a non-pharmacologic treatment. No significant differences in treatment prescriptions were found after a second or third fracture [5] . This study quantifies the high frequency of failure to diagnose and treat osteoporosis in patients with fragility fractures.…”

Section: Mexicomentioning

confidence: 82%

“…No significant differences in treatment prescriptions were found after a second or third fracture. [5] This study quantifies the high frequency of failure to diagnose and treat osteoporosis in patients with fragility fractures. Measures should be established to reduce the growing gap between osteoporosis diagnosis and treatment after a fragility fracture.…”

Section: Mexicomentioning

confidence: 99%

Fragility fracture systems, Latin America perspective

Rojas

Cervantes²,

Almejo

et al. 2022

OTA International: The Open Access Journal of Orthopaedic Trauma

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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.

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“…Research shows that the rate of treatment with anti-osteoporosis medication after surgical intervention for the rst fragility fracture is higher now than 10 years ago [5]. In various countries, however, there is a large gap between the number of patients who need osteoporosis treatment and the number of patients who actually receive osteoporosis treatment [6,7].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Subsequent Contralateral Proximal Femoral Fracture:More Convenient Access Needed to Treat Osteoporosis

Jiang

Zhu

Zhang

et al. 2023

Preprint

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Background Patients with proximal femoral fracture (PFF) have high mortality and many complications. Osteoporosis increases the risk of subsequent fractures, leading to subsequent contralateral PFF. This study was performed to analyze the features of individuals with subsequent PFF following surgical therapy of first PFF and to ascertain whether such patients received an examination or treatment of osteoporosis. The reasons for lack of examination or treatment were also analyzed. Methods This retrospective study involved 181 patients with subsequent contralateral PFF who underwent surgical treatment in Xi'an Honghui hospital from September 2012 to October 2021. The patients’ sex, age, hospital day, mechanism of injury, surgical procedure, fracture interval, fracture type, fracture classification, and Singh index of the contralateral hip at the time of the initial and subsequent fractures were recorded. Whether the patients took calcium and vitamin D supplements, used anti-osteoporosis medication, or underwent a dual X-ray absorptiometry (DXA) scan was recorded, as was the start time of each. Patients who had never undergone a DXA scan or received anti-osteoporosis medication took part in a questionnaire. Results The 181 patients in this study comprised 60 (33.1%) men and 121 (66.9%) women. Patients with initial PFF and subsequent contralateral PFF had a median age of 80 years (range, 49–96 years) and 82 years (range, 52–96 years), respectively. The median fracture interval was 24 (7–36) months. Contralateral fractures occurred at the highest incidence between 3 months and 1 year (28.7%). The Singh index was not significantly different between the two fractures. In 130 (71.8%) patients, the fracture type was the same. No significant difference was found in the fracture type or fracture stability classification. A total of 144 (79.6%) patients had never received a DXA scan or anti-osteoporosis medication. The main reason for not treating osteoporosis further was concern about the safety of drug interactions (67.4%). Conclusions Patients with subsequent contralateral PFF were of advanced age, had a higher proportion of intertrochanteric femoral fractures, had more severe osteoporosis, and had longer hospital stays. The difficulty managing such patients requires multidisciplinary involvement. Most of these patients were not screened or formally treated for osteoporosis. Advanced-age patients with osteoporosis need reasonable treatment and management.

show abstract

The yawning gap between osteoporosis diagnosis and treatment after a fragility fracture in Mexico

Cited by 5 publications

References 23 publications

Characteristics of subsequent contralateral proximal femoral fracture: more convenient access is needed to treat osteoporosis

Characteristics of subsequent contralateral proximal femoral fracture: more convenient access is needed to treat osteoporosis

Fragility fracture systems, Latin America perspective

Characteristics of Subsequent Contralateral Proximal Femoral Fracture:More Convenient Access Needed to Treat Osteoporosis

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