Sheehan J, Mohamed F, Reilly M, Perry I J
Department of Epidemiology and Public Health, University College Cork, Ireland.
Ir Med J. 2000 Jun;93(4):105-7.
Fractured neck of femur is one of the most common reasons for hospital admission in the elderly population. Despite this little attention is given to the area of secondary prevention. To assess the variation in clinical practice among orthopaedic surgeons with regard to the use of secondary preventive measures in relation to fractured neck of femur. A postal survey using a self-completed questionnaire among all orthopaedic surgeons throughout the Republic of Ireland. The study questionnaire addressed unit information prophylaxis for deep venous thrombosis and investigation and secondary prevention of fractured neck of femur. It gave a clinical scenario of a 72-year old female who was admitted with a fractured neck of femur after a minor fall. A reminder was sent to the non-responders. Data were analysed using chi-squared test. The number of completed questionnaires returned was 89 giving a response rate of 66%. Of these 71(82.6%) reported that they would not initiate or recommend investigation of the extent of the underlying osteoporosis in the specific case upon which the questionnaire was based. With regard to the issue of secondary prevention 16(18%) stated that they would prescribe Vitamin D and 26(29%) would prescribe calcium supplements. 15(17%) would use bisphosphonates and 15(17%) would prescribe hormone replacement therapy. Only one respondent would use an external hip protector. There is an underuse of secondary preventive measures with regard to fractured neck of femur. There needs to be clear definition of roles and perhaps the development of agreed local protocols in order that patients with hip fractures do not miss out on potentially beneficial treatment. There is an underuse of secondary preventive measures with regard to fractured neck of femur. There needs to be clear definition of roles and perhaps the development of agreed local protocols in order that patients with hip fractures do not miss out on potentially beneficial treatment.
股骨颈骨折是老年人群住院治疗的最常见原因之一。尽管如此，二级预防领域却很少受到关注。旨在评估骨科医生在股骨颈骨折二级预防措施使用方面的临床实践差异。在爱尔兰共和国所有骨科医生中进行了一项使用自填问卷的邮寄调查。研究问卷涉及单位信息、深静脉血栓形成的预防以及股骨颈骨折的调查和二级预防。问卷给出了一名72岁女性的临床病例，该女性因轻微跌倒后出现股骨颈骨折入院。向未回复者发送了提醒。使用卡方检验对数据进行分析。返回的完整问卷数量为89份，回复率为66%。其中71人（82.6%）报告称，他们不会针对问卷所基于的特定病例启动或建议对潜在骨质疏松症的程度进行调查。关于二级预防问题，16人（18%）表示会开维生素D，26人（29%）会开钙补充剂。15人（17%）会使用双膦酸盐，15人（17%）会开激素替代疗法。只有一名受访者会使用外部髋部保护器。在股骨颈骨折的二级预防措施方面存在使用不足的情况。需要明确角色定义，或许还需要制定商定的地方协议，以使髋部骨折患者不会错过潜在有益的治疗。在股骨颈骨折的二级预防措施方面存在使用不足的情况。需要明确角色定义，或许还需要制定商定的地方协议，以使髋部骨折患者不会错过潜在有益的治疗。
