ECTS2016 Poster Presentations Osteoporosis: treatment (40 abstracts)
Establishment of a large sector-spanning fracture liaison service in Germany
Wanja Wolters 1, , Markus Rossmann 1, , Jonas Pommerening 1, , Georg P Dahmen 2 , Andreas Schüsseler 2 , Catharina Bullmann 2 , Ingrid Weber 3 , Nils Ott 3 , Wolfgang Lehmann 1, & Eric Hesse 1,
1Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 2Osteoporosis-Network Hamburg, Hamburg, Germany; 3Eli Lilly and Company, Bone-Muscle-Joint Unit, Bad Homburg, Germany.
Patients with osteoporotic fractures are frequently treated in trauma surgery. While fracture fixation is at the center of patient care, treatment of the underlying bone disorder is often not considered, thereby increasing the risk for subsequent fractures. Closing this treatment gap is therefore among the greatest challenges in modern trauma surgery. To address this problem, we established a fully structured, multidisciplinary, sector-spanning fracture liaison service (FLS), which is among the first and largest in Germany serving a population of about two million people. Residents in trauma surgery at the local University Hospital who are dedicated to the FLS identified inpatients with an incident fragility fracture, focusing on postmenopausal women and men over 60 years of age. Next, patients answered a questionnaire to assess risk factors for fragility fractures and were provided with comprehensive information about the disease and the possibility to be treated within the FLS. All patients were free to choose one of 20 osteoporosis experts participating in the network to be referred to for further diagnosis and treatment. The multidisciplinary FLS consists of specialists in trauma- and orthopedic surgery, endocrinology and internal medicine, all working in private practice. Preliminary results demonstrate that about 20 patients per week can be included in the FLS, an efficacy that reaches more than 90% of patients fulfilling the inclusion criteria. To reach this goal, a highly motivated clinical FLS team is essential. Difficulties were encountered with patients suffering from dementia or other conditions compromising compliance. More clinical and logistic data are currently acquired and evaluated. We conclude that a multidisciplinary FLS is a powerful interface between inpatient surgical care and outpatient osteoporosis treatment. This system may reach the majority of patients with fragility fractures and can subject them to an adequate treatment, which will reduce morbidity, mortality and the socio-economic costs.
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Bone Abstracts
ISSN 2052-1219 (online)
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