INSERM UMR 1153, Equipe ECSTRRA, Service de Biostatistique et Information Médicale, AP-HP Hôpital Saint Louis/Université Paris Diderot, 75010 Paris, France.
Department of Radiology, Tenon Hospital, Sorbonne Université, 4 rue de la Chine, 75020 Paris, France.
Medicina (Kaunas). 2020 Aug 7;56(8):397. doi: 10.3390/medicina56080397.
: Hip fracture is a major public health issue. Those fractures lead to high costs and a decrease in quality of life. A national French survey was conducted, with the objectives to firstly assess the current management of hip fracture and its prevention, both in the osteoporotic and cancer settings, and secondly to evaluate the opinions of physicians on the potential use of minimally invasive implantable devices to prevent hip fracture in alternative of surgery. : This national survey was conducted in France between April and July 2017. Questionnaires were sent to orthopedic surgeons, interventional radiologists, oncologists, and rheumatologists. Completed questionnaires were analyzed and compared according to two indications: orthopedics-traumatology and oncology. Factors associated with these responses were assessed using univariable analyses, based on chi-square tests or an exact Fisher test, as appropriate. : A total of 182 questionnaires were completed and further analyzed. Physicians have highlighted the need for a low re-fracture rate and to improve life expectancy for more than 1 year (50% for responders of the orthopedics-traumatology questionnaire and 80% for the responders interested in both indications), as well as quality of life (12.5% and 31%, respectively), but with no significant differences in the oncologic indication. Most of the experts were willing to use or prescribe implantable devices for prevention (63% in orthopedics-traumatology and 93% in oncology), although limited clinical experience (54 and 58%) and surgical risk (around 30% in each indication) were considered as limits. Prevention of hip fracture remains a concern for physicians. More clinical experience with implantable devices, in particular in cancer patients, is needed, but implemented in a strategy to maximize patient recovery while reducing costs.
髋部骨折是一个重大的公共卫生问题。这些骨折导致了高昂的成本和生活质量的下降。进行了一项全国性的法国调查,目的是首先评估髋部骨折及其在骨质疏松症和癌症环境中的预防的当前管理,其次评估医生对使用微创植入装置预防髋部骨折以替代手术的潜在用途的意见。
这项全国性调查于 2017 年 4 月至 7 月在法国进行。向骨科医生、介入放射科医生、肿瘤学家和风湿病学家发送了问卷。对完成的问卷进行了分析和比较,根据两种适应症:骨科-创伤学和肿瘤学。使用基于卡方检验或确切 Fisher 检验的单变量分析,评估与这些反应相关的因素。
共完成并进一步分析了 182 份问卷。医生强调需要降低再骨折率并提高预期寿命超过 1 年(骨科-创伤学问卷的回答者中为 50%,对两种适应症均感兴趣的回答者中为 80%),以及生活质量(分别为 12.5%和 31%),但在肿瘤学适应症方面没有显著差异。大多数专家愿意使用或开处植入物进行预防(骨科-创伤学为 63%,肿瘤学为 93%),尽管临床经验有限(分别为 54%和 58%)和手术风险(每种适应症约为 30%)被认为是限制。预防髋部骨折仍然是医生关注的问题。需要更多关于植入物的临床经验,特别是在癌症患者中,但要实施一项策略,最大限度地提高患者的康复,同时降低成本。