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Recommendations on the post-acute management of the osteoporotic fracture - Patients with “very-high” Re-fracture risk

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 o...

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Autores principales: Wong, Ronald Man Yeung, Cheung, Wing-Hoi, Chow, Simon Kwoon Ho, Ng, Raymond Wai Kit, Li, Wilson, Hsu, Albert Yung-Chak, Wong, Kam Kwong, Ho, Angela Wing-Hang, Choi, Shing-Hing, Fang, Christian Xinshuo, Chan, Chun Fung, Leung, Ka-Hei, Chu, Kwok-Keung, Kwok, Timothy Chi Yui, Yang, Ming Hui, Tian, Maoyi, Law, Sheung Wai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Chinese Speaking Orthopaedic Society 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562437/
https://www.ncbi.nlm.nih.gov/pubmed/36262963
http://dx.doi.org/10.1016/j.jot.2022.09.010
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author Wong, Ronald Man Yeung
Cheung, Wing-Hoi
Chow, Simon Kwoon Ho
Ng, Raymond Wai Kit
Li, Wilson
Hsu, Albert Yung-Chak
Wong, Kam Kwong
Ho, Angela Wing-Hang
Choi, Shing-Hing
Fang, Christian Xinshuo
Chan, Chun Fung
Leung, Ka-Hei
Chu, Kwok-Keung
Kwok, Timothy Chi Yui
Yang, Ming Hui
Tian, Maoyi
Law, Sheung Wai
author_facet Wong, Ronald Man Yeung
Cheung, Wing-Hoi
Chow, Simon Kwoon Ho
Ng, Raymond Wai Kit
Li, Wilson
Hsu, Albert Yung-Chak
Wong, Kam Kwong
Ho, Angela Wing-Hang
Choi, Shing-Hing
Fang, Christian Xinshuo
Chan, Chun Fung
Leung, Ka-Hei
Chu, Kwok-Keung
Kwok, Timothy Chi Yui
Yang, Ming Hui
Tian, Maoyi
Law, Sheung Wai
author_sort Wong, Ronald Man Yeung
collection PubMed
description 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. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE: 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.
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spelling pubmed-95624372022-10-18 Recommendations on the post-acute management of the osteoporotic fracture - Patients with “very-high” Re-fracture risk Wong, Ronald Man Yeung Cheung, Wing-Hoi Chow, Simon Kwoon Ho Ng, Raymond Wai Kit Li, Wilson Hsu, Albert Yung-Chak Wong, Kam Kwong Ho, Angela Wing-Hang Choi, Shing-Hing Fang, Christian Xinshuo Chan, Chun Fung Leung, Ka-Hei Chu, Kwok-Keung Kwok, Timothy Chi Yui Yang, Ming Hui Tian, Maoyi Law, Sheung Wai J Orthop Translat Original Article 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. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE: 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. Chinese Speaking Orthopaedic Society 2022-10-10 /pmc/articles/PMC9562437/ /pubmed/36262963 http://dx.doi.org/10.1016/j.jot.2022.09.010 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Wong, Ronald Man Yeung
Cheung, Wing-Hoi
Chow, Simon Kwoon Ho
Ng, Raymond Wai Kit
Li, Wilson
Hsu, Albert Yung-Chak
Wong, Kam Kwong
Ho, Angela Wing-Hang
Choi, Shing-Hing
Fang, Christian Xinshuo
Chan, Chun Fung
Leung, Ka-Hei
Chu, Kwok-Keung
Kwok, Timothy Chi Yui
Yang, Ming Hui
Tian, Maoyi
Law, Sheung Wai
Recommendations on the post-acute management of the osteoporotic fracture - Patients with “very-high” Re-fracture risk
title Recommendations on the post-acute management of the osteoporotic fracture - Patients with “very-high” Re-fracture risk
title_full Recommendations on the post-acute management of the osteoporotic fracture - Patients with “very-high” Re-fracture risk
title_fullStr Recommendations on the post-acute management of the osteoporotic fracture - Patients with “very-high” Re-fracture risk
title_full_unstemmed Recommendations on the post-acute management of the osteoporotic fracture - Patients with “very-high” Re-fracture risk
title_short Recommendations on the post-acute management of the osteoporotic fracture - Patients with “very-high” Re-fracture risk
title_sort recommendations on the post-acute management of the osteoporotic fracture - patients with “very-high” re-fracture risk
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562437/
https://www.ncbi.nlm.nih.gov/pubmed/36262963
http://dx.doi.org/10.1016/j.jot.2022.09.010
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