Dresdener Network Osteoporosis: Effect of Networking on Diagnosis and Therapy of Osteoporosis

PURPOSE: On a global scale the main focus of traumatological therapy lies in the treatment of unintentional injuries or victims of violence. People of all ages and through all economic groups can be affected. Due to demographic change in Western industrial countries, however, this focus increasingly shifts towards fragility fractures. In Europe osteoporosis is the most common bone disease in advanced age. Secondary prevention programs like the Fracture Liaison Service (FLS) are becoming increasingly prevalent, especially in Anglo-American health care systems. In German orthopedic and trauma wards and hospitals, however, the FLS is still relatively uncommon. This article will examine the question whether secondary prevention programs like FLS need to be established in the German health care system. This study aims at finding out, whether in the area of a medium sized German city there is a difference regarding the initiation of osteoporosis diagnosis and therapy between the regular aftercare by the general practitioner or the orthopedic surgeon and the aftercare by a specialist trained in osteology (Osteologe). MATERIALS AND METHODS: For the open, randomized prospective study 70 patients with low energy fractures were recruited, who were older than 60 years and have been treated in our department. RESULTS: 58 out of 70 patients have completed the study, which amounts to a follow-up of 82.9%. Limited mobility and a high degree of organizational effort were the main reasons for early termination of the study. While in the group with regular aftercare, only 2 out of 29 patients received a specific osteoporosis treatment, in group who were directly transferred to a specialist trained in osteology 17 out of 29 patients received specific treatment. After re-evaluation of group with regular aftercare in 21 out of 29 cases a specific osteoporosis treatment was recommended. SCHLUSSFOLGERUNG: Es konnte gezeigt werden, dass ein signifikanter Unterschied in der Einleitung von Diagnostik- und Therapie in der Nachbehandlung von Frakturpatienten zwischen den Osteologen und den Hausarzten bzw. den Chirurgen gibt. Durch die Bildung von sektorenubergreifenden Netzwerken mit einem geriatrisch-orthopadisch-unfallchirurgischen Hintergrund (z. B. FLS), kann eine deutliche Verbesserung der Nachsorge von Frakturpatienten im deutschen Gesundheitssystem erreicht werden, um diesen eine mogliche Folgefraktur zu ersparen.