gms | German Medical Science

Objectives: Minor Trauma Fractures (MTF) in elderly are common and impose a burden on public health. They increase mortality and morbidity as well as the occurrence of subsequent fractures. MTF patients often have an underlying bone disease, mostly osteoporosis. Osteoporosis is, however, known to be underdiagnosed and undertreated. Efficient treatment of osteoporosis can reduce fracture risk. In our hospital, this led to the implementation of an intervention to foster screening and treatment of osteoporosis, with the goal to reduce the risk of subsequent fracture.

The primary aim was to assess the efficacy of an intervention for improving secondary prevention of MTF by implementing a dedicated health professional team.

Methods: Prospective, single-centre cohort study of MTF patients, older than 50 years. A standardized questionnaire and telephone interview were used to collect one year follow-up data. Primary outcome was the amount of subsequent fractures due to a fall. Secondary outcomes were: amount of patients undergoing DXA scanning, diagnosis of osteoporosis or osteopenia and intake of specific osteoporosis treatment. Data on DXA scanning and diagnosis of osteoporosis/osteopenia were compared to the results of a previous study in the same centre, published in 2004.

Result: A total of 411 patients were included. Mean age was 72±9.3. Fifteen patients (3.9%) had a secondary fracture as a result of a fall. 252 (63.3%) patients received a DXA scan as compared to 12.6% reported in our previous study. Of all patients who received a DXA scan, 199 (82.9%) were diagnosed with osteoporosis or osteopenia. A total of 90 patients (21.9%) received specific treatment for osteoporosis.

In conclusion, the refracture rate in our study is lower compared to other studies. Furthermore, compared to 2004, a larger number of MTF patients in our hospital underwent osteoporosis screening and -treatment after implementation of a dedicated health professional team. Thus, this study shows that a minimal intervention program for the management of patients with MTF improved the rate of patients who undergo DXA screening and may contribute to prevent subsequent fractures. Nevertheless, over a third of the patients did not receive a DXA scan and only 22% received specific medication for osteoporosis after one year of follow-up. Consequently, this tailored intervention is a promising first step in improving geriatric fracture care, however, there remains room for improvement.