Les messages clés des recherches scientifiques sur lesquels on peut agir
J'ai compris, masquez ceciLems WF, Dreinhofer KE, Bischoff-Ferrari H, et al. Les recommandations de l'EULAR/EFORT pour la prise en charge des patients âgés de plus de 50 ans avec une fracture de fragilité et pour la prévention des fractures subséquentes. Ann Rheum Dis. 2016 Dec 22. Epub ahead of print.
In adults 50 years of age or older with fragility fractures, what are the recommendations from the European League Against Rheumatism (EULAR) and the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) for preventing future fractures?
A fragility fracture is a fracture (broken bone) that results from a fall from a low height (standing height or less). A fragility fracture is often a sign that the bones are fragile, usually due to osteoporosis (a disease that causes a breakdown of bone tissue).
People older than 50 years who have fragility fractures generally need health care from more than one medical specialty, including surgeons, rheumatologists and bone specialists, general practitioners, and rehab specialists. These specialists need to work closely together.
The researchers agreed on the 10 most important questions for treating people with fragility fractures and preventing future fractures. They did a systematic review, searching for studies related to those 10 questions. A group of experts participated in an in-depth process that involved repeatedly reviewing the results of the systematic review, formulating and revising recommendations, assessing agreement of recommendations, incorporating feedback from experts outside the group, and evaluating the strength of each recommendation.
The 10 recommendations from the group are shown in the Table below.
10 recommendations describe how health care providers from different specialties should work together to care for adults 50 years of age or older with fragility fractures and to prevent future fractures.
Recommendations |
Doctors from different specialties should manage treatment of fragility fractures to ensure people have
|
Doctors who specialize in treatment of elderly people (e.g., geriatricians) should be involved in care, especially for elderly people with hip fractures. |
Treatment of fractures requires balancing the risks and benefits of different options for surgery and other treatments. |
All people should be carefully assessed for their risk for future fractures. |
Assessment of risk for future fractures includes:
|
One health care professional should be responsible for:
|
Rehabilitation should include:
|
People should be taught about their illness, risk factors for fractures, and treatments. |
Non-drug treatments are important for preventing future fractures in people at high risk, and include:
|
Drugs that are known to reduce risk of vertebral, nonvertebral, and hip fractures should be used. Tolerance and adherence to drugs should be monitored by doctors. |