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哨兵骨折:改善骨折后护理的必要性。

Sentinel fracture: the necessity of improved post-fracture care.

作者信息

Kerschan-Schindl Katharina, Widhalm Harald, Pataraia Anna, Nicolakis Peter, Frossard Martin, Keilani Mohammad, Mickel Michael, Hajdu Stefan, Crevenna Richard

机构信息

Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna/Vienna General Hospital, Vienna, Austria.

Department of Orthopedics and Trauma-Surgery, Clinical Division of Traumatology, Medical University of Vienna/Vienna General Hospital, Vienna, Austria.

出版信息

Wien Med Wochenschr. 2025 Feb;175(1-2):3-10. doi: 10.1007/s10354-024-01066-4. Epub 2024 Nov 29.

Abstract

Fragility fractures caused by osteoporosis, the most common metabolic bone disease, place a significant burden on affected individuals and impose substantial economic costs. A fragility fracture implies an imminent elevated risk for subsequent fractures, particularly in the short term. Therefore, osteoporosis must be addressed in the event of a sentinel fracture, if not already previously treated. Regardless of whether the fracture is treated conservatively or surgically, post-fracture care is particularly important. Early mobilization followed by fall risk assessment and the initiation of adequate bone-specific medication are essential milestones in preventing subsequent fractures. Monitoring patients increases adherence to bone-specific medication and fall prevention strategies. Comprehensive post-fracture care is important and should be performed by a multidisciplinary team. Coordinated care models, such as the fracture liaison service (FLS), have shown enhancements in the initiation of and adherence to secondary prevention of fragility fractures. Despite recommendations by several guidelines including that published by the Austrian Society for Bone and Mineral Research, only one fracture liaison service has been implemented in Austria.

摘要

骨质疏松症作为最常见的代谢性骨病,其所导致的脆性骨折给患者个体带来了沉重负担,并产生了巨额经济成本。脆性骨折意味着后续骨折风险即刻升高,尤其是在短期内。因此,若出现首次骨折(即使此前未接受过治疗),就必须对骨质疏松症进行治疗。无论骨折是采用保守治疗还是手术治疗,骨折后的护理都尤为重要。早期活动,随后进行跌倒风险评估并开始使用适当的抗骨质疏松药物,是预防后续骨折的关键环节。对患者进行监测可提高其对骨特异性药物和预防跌倒策略的依从性。全面的骨折后护理很重要,应由多学科团队来开展。诸如骨折联络服务(FLS)等协调护理模式已显示出在脆性骨折二级预防的启动和依从性方面有所改善。尽管包括奥地利骨与矿物质研究学会发布的指南在内的多项指南都给出了相关建议,但奥地利仅实施了一项骨折联络服务。

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