Bone well being is prime of thoughts for a lot of throughout Osteoporosis Consciousness and Prevention Month. That is very true for the 44 million Individuals who’ve low bone density, inserting them at an elevated danger for damaged bones.

One of many extra frequent sorts of damaged bones sufferers with low bone density expertise are fragility fractures, that are fractures ensuing from a fall from standing peak or much less.

“Fragility fractures, which mostly happen on the hip, backbone, or wrist, are a sign that the physique’s bones have been weakened by an underlying situation,” defined Hai Le, assistant professor of orthopaedic surgical procedure. “Due to this fact, the affected person on the highest danger of a fragility fracture is somebody who has simply had one.”

A latest research performed by Le and his crew discovered that sufferers who’ve had a fragility fracture usually tend to expertise one other one sooner or later. It additionally highlighted the dearth of follow-up care to forestall these sufferers from doubtlessly struggling one other fragility fracture. The researchers urged instances of osteoporosis must be handled earlier on within the medical course of.

A multidisciplinary method to fragility fractures

“When a affected person experiences a fragility fracture that requires surgical procedure it’s our job to get these sufferers again on their toes, however we’re not the specialists in relation to stopping the subsequent fracture,” mentioned Le. “That is after we herald our colleagues from endocrinology and rheumatology, who’re the specialists in diagnosing and treating osteoporosis or different sicknesses associated to low bone density.”

To assist these sufferers, a multidisciplinary collaboration amongst UC Davis Well being’s departments of orthopedic surgical procedure, endocrinology, rheumatology and geriatric care have shaped a Fragility Fracture Program. The aim is to make sure that sufferers that suffer a fragility fracture obtain complete therapy to forestall future fractures. They’ll additionally determine sufferers who may be in danger for future fractures.

Based on the Nationwide Osteoporosis Basis, roughly half of all ladies and as much as one-quarter of all males will endure a fragility fracture of their lifetime. Individuals who have had a earlier fragility fracture are twice as prone to endure a fracture sooner or later. Particularly in sufferers over 65, fragility fractures can result in elevated danger of psychological and bodily issues and a major lower in mobility and high quality of life. Some fragility fractures can have a mortality fee as excessive as 33% throughout the first 12 months.

Diagnosing and treating osteoporosis early

“My function in diagnosing osteoporosis consists of conducting a whole laboratory screening of potential danger components from a hormonal standpoint,” defined Polly Teng, assistant professor of endocrinology and orthopaedic surgical procedure.

A few of the laboratory assessments embrace a affected person’s vitamin D, calcium, and parathyroid and thyroid hormone ranges, all of which may have an effect on bone fragility. Different assessments may be ordered as effectively, based mostly on every particular person affected person’s wants.

“These therapies may also help handle the underlying causes of a affected person’s bone fragility, enhance bone stability, and stop future fractures,” mentioned Barton L. Smart, affiliate professor of rheumatology and orthopaedic surgical procedure. “There are lots of good drugs to deal with sicknesses that impact bone density and diagnosing our sufferers correctly permits us to determine the very best care plan for every affected person, and in addition consider if they’ve another underlying problems.”

Sufferers additionally obtain visits from nutritionists who present dietary steerage, and bodily therapists who lead them by means of workout routines to strengthen supporting muscle mass and enhance stability and mobility to deal with fall dangers.

Clinician at UC Davis Well being Mobility Clinic observing affected person’s gait patterns

Bettering mobility to forestall falls

Upon discharge, sufferers 65 and older who’ve been hospitalized for a fragility fracture are referred to UC Davis Well being’s new mobility program on the Wholesome Ageing Clinic. This one-stop clinic serves sufferers and their caregivers, permitting them to leverage built-in specialty medical care and providers that may result in higher high quality of life and facilitate impartial dwelling.

“We take a geriatric method with our mobility clinic,” mentioned Alia Tuqan, who’s a board-certified geriatrician and interim medical director of the clinic. “We begin with a bodily examination to evaluate their dangers for an extra fall, then work with the affected person and any caregivers to formulate a plan to forestall one other fall.”

The mobility program is run by clinic nurse practitioners. In the course of the exams, they consider a affected person’s imaginative and prescient, neuropathy, orthostatics, cognitive impairment and any medicines that would improve the affected person’s danger of falling.

“We actually are targeted on offering affected person centered care,” Tuqan mentioned. “With regards to mobility and fall prevention you possibly can’t give attention to one explicit drawback, we’re targeted on serving to the affected person dwell their greatest life potential in order that they are often as practical and glad as potential.”

Elevated preventive therapy applications like UC Davis Well being’s Fragility Fracture Program may have a significant influence on public well being in america and the excessive prices related to it. The Nationwide Osteoporosis Basis reported that roughly 1.8 million Medicare beneficiaries suffered roughly 2.1 million osteoporotic fractures in 2016.

“If we may scale back secondary fracture growth by simply 20%, we may doubtlessly save Medicare over one billion {dollars} yearly,” Le mentioned. “Complete fracture applications may enhance affected person outcomes, and in addition present our Medicare system extra assets to assist different applications.”


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