Students' Scientific Research Center (SSRC), Exceptional Talent Development Center (ETDC), Tehran University of Medical Sciences (TUMS), Shahrake Ekbatan, 1394813799 Tehran, Iran.
Orthop Traumatol Surg Res. 2013 Oct;99(6):723-30. doi: 10.1016/j.otsr.2013.03.022. Epub 2013 Jul 10.
Osteoporosis has been described as a progressive skeletal disorder until a patient experiences a fragility fracture. The number of patients with osteoporotic fractures is increasing at an exponential rate. Orthopaedic surgeons, most of the time, first clinicians seen by patients at the time of fracture, do not routinely consider osteoporosis management. Therefore, we compared the knowledge of orthopaedic surgeons and internists regarding medical treatment required: which group would have more abilities to keep patients with osteoporotic fractures under management?
We hypothesize that internists may have more abilities to assess and treat osteoporosis for patients with osteoporotic fractures; therefore, referring these patients to this specialized team for post-fracture medical consultation is required.
A questionnaire composed of seven closed questions was administered to 4700 orthopaedic surgeons and internists. This question list addressed the orthopaedic surgeons' and internists' knowledge in managing patients with osteoporotic fractures. The questions were designed in a way to cover the topics of diagnosis, treatment, and approach to an osteoporotic patient with osteoporotic fractures.
In this survey, 3431 respondents were included. Only 118 (fewer than 10%) orthopaedic surgeons would order bone mineral densitometry (BMD) in osteoporotic fractures in contrast to 1544 (79%) internists. Approximately 1485 (76%) internists against 487 (33%) orthopaedic surgeons prescribe proper dosage of calcium and vitamin D.
Typical orthopaedic surgeon is not naturally inclined to manage patients with osteoporotic fractures. The existing management gap between the occurrence of an osteoporotic fracture and the identification and treatment of osteoporosis requires multifaceted intervention. Improved communication between orthopaedic surgeons and internists may reduce this gap between fracture occurrence and osteoporosis management.
Level III prospective diagnostic study.
骨质疏松症被描述为一种进行性骨骼疾病，直到患者发生脆性骨折。骨质疏松性骨折患者的数量呈指数级增长。骨科医生通常是患者骨折时首先就诊的临床医生，但他们并不常规考虑骨质疏松症的管理。因此，我们比较了骨科医生和内科医生在骨质疏松症药物治疗方面的知识：哪一组更有能力管理骨质疏松性骨折患者？
我们假设内科医生可能更有能力评估和治疗骨质疏松性骨折患者；因此，需要将这些患者转介给这个专门的团队进行骨折后医疗咨询。
我们向 4700 名骨科医生和内科医生发放了一份由七个封闭式问题组成的问卷。这个问题列表涉及到骨科医生和内科医生管理骨质疏松性骨折患者的知识。这些问题的设计旨在涵盖骨质疏松症患者的诊断、治疗和处理等方面。
在这项调查中，共纳入 3431 名受访者。只有 118 名（不到 10%）骨科医生会在骨质疏松性骨折患者中开骨密度测定（BMD）检查，而 1544 名（79%）内科医生会开。大约 1485 名（76%）内科医生会开适当剂量的钙和维生素 D，而 487 名（33%）骨科医生会开。
典型的骨科医生并不倾向于管理骨质疏松性骨折患者。骨质疏松性骨折的发生与骨质疏松症的识别和治疗之间存在管理差距，需要多方面的干预。骨科医生和内科医生之间加强沟通可能会缩小这一差距。
III 级前瞻性诊断研究。
