Fragility fractures in women and men older than 50 years are among the most frequent musculoskeletal manifestations for which patients consult healthcare workers from more than one medical specialty. Immediately following a fracture, the patient needs acute fracture care, supplied by an orthopaedic or trauma surgeon. This is followed in a later phase by subsequent fracture prevention in patients identified at high risk for a subsequent fracture, usually under the responsibility of rheumatologists or other bone disease experts. Thus, at a local level, a close collaboration between these specialities is necessary. Both the European League Against Rheumatism (EULAR) and the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) have recognised the importance of optimal fracture care and prevention of subsequent fractures in high-risk patients and have therefore collaboratively initiated this recommendation.
The recommendations will be discussed during the meeting. Some overarching principles that play a crucial role in the recommendations are:
– especially in the frail elderly with a major fracture, an orthogeriatric and multidisciplinairy approach in an in-hospital setting is warranted, to avoid complications, delirium, and prevent increased morbidity and mortality
– optimal care in the preoperative, operative and postoperative phase has an important effect on clinical outcome. As a consequence, it is very likely that limited mobility and a low quality of life in the postoperative phase may have an elevated risk of future fractures.
– for prevention of subsequent fractures, it is important that in all patients fracture risk will be investigated systematically, including DXA, imaging of the spine, fall risk evaluation and screening for secondary osteoporosis.
– for subsequent prevention of fractures in high risk patients, not only effective and safe drugs should be prescribed, but non-pharmacological treatment options and patient education are also crucial.
Disclosure of Interest None declared