[Management of osteoporosis after fragility fractures]

Z Gerontol Geriatr. 2018 Jan;51(1):113-125. doi: 10.1007/s00391-017-1355-7. Epub 2018 Jan 5.
[Article in German]

Abstract

Osteoporosis is defined as a systemic bone disease with decreased bone strength and an increased susceptibility for fractures. Older people in particular face an increased risk of fractures. These kind of fractures are usually caused by an inadequate trauma and are the so-called fragility fractures. In older adults immediate fracture stabilization and early mobilization have become the standard procedure after a fragility fracture. Treatment of the underlying osteoporosis often plays a minor role in clinical practice. Only a small group of patients are already under osteoporosis medication and even after a fracture occurs only few patients receive osteoporosis drug treatment with the aim to reduce the progression of osteoporosis and to reduce subsequent fractures. In the literature this has been described as the osteoporosis care gap. The following article presents an overview of treatment options and answers many different questions from the clinical routine.

Keywords: Denosumab; Diphosphonates; Orthogeriatrics; Practice gap; Therapy failure.

Publication types

  • Review

MeSH terms

  • Absorptiometry, Photon
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Bone Density Conservation Agents / therapeutic use
  • Denosumab / therapeutic use
  • Diphosphonates / therapeutic use
  • Early Ambulation
  • Female
  • Fracture Fixation
  • Germany
  • Guideline Adherence
  • Hip Fractures / diagnosis
  • Hip Fractures / etiology
  • Hip Fractures / therapy
  • Humans
  • Male
  • Osteoporosis / diagnosis
  • Osteoporosis / etiology
  • Osteoporosis / therapy*
  • Osteoporotic Fractures / diagnosis
  • Osteoporotic Fractures / etiology
  • Osteoporotic Fractures / prevention & control
  • Osteoporotic Fractures / therapy*
  • Professional Practice Gaps
  • Risk Factors
  • Spinal Fractures / diagnosis
  • Spinal Fractures / etiology
  • Spinal Fractures / therapy

Substances

  • Bone Density Conservation Agents
  • Diphosphonates
  • Denosumab