Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.
Department of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
Curr Osteoporos Rep. 2024 Dec;22(6):611-620. doi: 10.1007/s11914-024-00885-z. Epub 2024 Sep 10.
We review the literature about patients 50 years and older with a recent clinical fracture for the presence of skeletal and extra-skeletal risks, their perspectives of imminent subsequent fracture, falls, mortality, and other risks, and on the role of the fracture liaison service (FLS) for timely secondary fracture prevention.
Patients with a recent clinical fracture present with heterogeneous patterns of bone-, fall-, and comorbidity-related risks. Short-term perspectives include bone loss, increased risk of fractures, falls, and mortality, and a decrease in physical performance and quality of life. Combined evaluation of bone, fall risk, and the presence of associated comorbidities contributes to treatment strategies. Since fractures are related to interactions of bone-, fall-, and comorbidity-related risks, there is no one-single-discipline-fits-all approach but a need for a multidisciplinary approach at the FLS to consider all phenotypes for evaluation and treatment in an individual patient.
我们回顾了最近有临床骨折的 50 岁及以上患者的骨骼和骨骼外风险的文献,包括其对即将发生的后续骨折、跌倒、死亡率和其他风险的看法,以及骨折联络服务(FLS)在及时进行二级骨折预防方面的作用。
近期有临床骨折的患者存在着不同类型的骨、跌倒和合并症相关风险。短期观点包括骨丢失、骨折、跌倒和死亡率风险增加,以及身体机能和生活质量下降。综合评估骨、跌倒风险和并存的合并症有助于制定治疗策略。由于骨折与骨、跌倒和合并症相关风险的相互作用有关,因此不存在一种单一的治疗方法,而是需要在 FLS 采用多学科方法,考虑所有表型,对个体患者进行评估和治疗。