Secondary Fracture Prevention

Secondary Fracture Prevention: An International Perspective presents practitioners and academic clinicians with a better understanding of secondary fracture prevention and models of care from a variety of settings and countries. This must-have guide provides practitioners and academic clinicians with essential information about this broad clinical and research topic that extends across the globe. Preventing secondary fractures starts with assessing what works and what does not work, reviewing major society guidelines, and what workup and management is necessary. This book reviews these topics and provides the rationale for pursuing a workup to prevent fractures in this patient population.

Secondary Fracture Prevention: An International Perspective presents practitioners and academic clinicians with a better understanding of secondary fracture prevention and models of care from a variety of settings and countries. This must-have guide provides practitioners and academic clinicians with essential information about this broad clinical and research topic that extends across the globe. Preventing secondary fractures starts with assessing what works and what does not work, reviewing major society guidelines, and what workup and management is necessary. This book reviews these topics and provides the rationale for pursuing a workup to prevent fractures in this patient population. Provides an international perspective, giving health professionals in different parts of the world essential information to establish country-specific, secondary fracture prevention programs Summarizes existing literature on secondary fractures and includes a description of the risks and how they can be prevented Highlights secondary fracture prevention and models of care

This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.

This new open access edition supported by the Fragility Fracture Network aims at giving the widest possible dissemination on fragility fracture (especially hip fracture) management and notably in countries where this expertise is sorely needed. It has been extensively revised and updated by the experts of this network to provide a unique and reliable content in one single volume. Throughout the book, attention is given to the difficult question of how to provide best practice in countries where the discipline of geriatric medicine is not well established and resources for secondary prevention are scarce. The revised and updated chapters on the epidemiology of hip fractures, osteoporosis, sarcopenia, surgery, anaesthesia, medical management of frailty, peri-operative complications, rehabilitation and nursing are supplemented by six new chapters. These include an overview of the multidisciplinary approach to fragility fractures and new contributions on pre-hospital care, treatment in the emergency room, falls prevention, nutrition and systems for audit. The reader will have an exhaustive overview and will gain essential, practical knowledge on how best to manage fractures in elderly patients and how to develop clinical systems that do so reliably.

There are a number of therapies and treatments available for the prevention of fragility fractures in people thought to be at risk, or to prevent further fractures in those who have already had one or more fragility fractures. However, identifying who will benefit from preventative treatment is imprecise. A number of risk assessment tools are available to predict fracture incidence over a period of time, and these may be used to aid decision making. These tools are limited in that they may not include all risk factors, or may lack details of some risk factors. Tools are dependent on the accuracy of the epidemiological data used to derive them and tools validated in other populations may not apply to the UK. Two tools, FRAX and QFracture, are available for use in the UK. It is not clear whether these tools are equally accurate and whether choice of tool should depend on circumstances. This short clinical guideline aims to provide guidance on the selection and use of risk assessment tools in the care of people who may be at risk of fragility fractures in all settings in which NHS care is received.

This issue of Clinics in Geriatric Medicine is centered on the management of the geriatric fragility fracture patient. This issue features expert clinical reviews on topics such as Principles of comanagement, Lean business model and implementation of a Geriatric Fracture Center, Preoperative optimization and risk assessment, Preoperative reversal and management of anticoagulation and antiplatelet agents, Classification and surgical approach to hip fractures for non-surgeons, Special anesthetic consideration for the fragility fracture patient, Non-surgical management and palliation of fragility fractures, and Management of post-operative complications including Delerium, Anemia, Venous thromboembolism, and Cardiovascular disease and volume management. Also included are articles on Transitions in care and rehabilitation, Osteoporosis related secondary fracture prevention, Post-operative assessment of falls risk and prevention, and Fragility fractures requiring special consideration.

This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.; Provides a comprehensive discussion of nursing the frail older person with a fragility fracture across Europe Based on a two-day workshop of like-minded specialist and advanced nurses from over 20 countries Acts as the course text/reader for a Europe-wide education programme in all relevant settings (Emergency Department, Fracture Clinic, Trauma Unit, Orthopaedic Ward, Rehabilitation setting) Open Access This work was published by Saint Philip Street Press pursuant to a Creative Commons license permitting commercial use. All rights not granted by the work's license are retained by the author or authors.