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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...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Chinese Speaking Orthopaedic Society
2022
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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. |
format | Online Article Text |
id | pubmed-9562437 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Chinese Speaking Orthopaedic Society |
record_format | MEDLINE/PubMed |
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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