Survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association

Lee JK 1 , Mitchell PJ 2 , Ang SB 3 , Mercado-Asis LB 3 , Rey-Matias R 4 , Li J 4 Show all authors , Flicker L 5 , Leung E 5 , Choon D 6 , Chandrasekaran SK 6 , Close JCT 7 , Seymour H 7 , Cooper C 8 , Halbout P 8 , Blank RD 9 , Zhao Y 9 , Malhotra R 10 , Unnanuntana A 11 , Woo YL 12 , Noor Z 13 , Yang RS 14 , Tabu I 15 , Islam SS 16 , Chinoy MA 17 , Pande S 18 , Thapa B 19 , Wong RMY 20 , Pande K 21 , Chan DD 22 , Asia Pacific Fragility Fracture Alliance and the Asia Pacific Osteoporosis and Fragility Fracture Society

Affiliations 

  • 1 Beacon Hospital, Department of Orthopedics, Petaling Jaya, Malaysia. osteoporosis_jklee@yahoo.com
  • 2 School of Medicine, University of Notre Dame Australia, Sydney, Australia
  • 3 Asian Federation of Osteoporosis Societies, c/o, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, Singapore
  • 4 Asia-Oceanian Society of Physical and Rehabilitation Medicine, Kowloon, Hong Kong SAR, China
  • 5 Asia Pacific Geriatric Network, virtual network, Perth, Australia
  • 6 Asia Pacific Orthopaedic Association, Bukit Jalil, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  • 7 Fragility Fracture Network, Reinacherstrasse 131, 4053, Basel, Switzerland
  • 8 International Osteoporosis Foundation, Nyon, Switzerland
  • 9 International Society for Clinical Densitometry, Middletown, CT, USA
  • 10 Department of Orthopaedics, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
  • 11 Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 12 Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
  • 13 Department of Orthopaedic and Traumatology, Ulin General Hospital, Banjarmasin, Indonesia
  • 14 Department of Orthopaedic Surgery, National Taiwan University & Hospital, Taipei, Taiwan
  • 15 Department of Orthopedics, University of the Philippines-Philippine General Hospital, Manila, Philippines
  • 16 Department of Orthopaedics and Spine Surgery, Evercare Hospital, Dhaka, Bangladesh
  • 17 Department of Trauma and Orthopaedics, The Indus Hospital, Korangi Crossing, Karachi, Pakistan
  • 18 Territory Sportsmedicine, Darwin, NT, Australia
  • 19 Department of Orthopaedics and Trauma, Nepal Academy of Science and Technology, Bir Hospital, Kathmandu, Nepal
  • 20 Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
  • 21 Department of Orthopaedics, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam
  • 22 Department of Geriatrics and Gerontology and Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. dingchengchan@ntu.edu.tw
Arch Osteoporos, 2024 Apr 02;19(1):24.
PMID: 38565791 DOI: 10.1007/s11657-024-01375-6

Abstract

A survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association conducted in 2022 found considerable variation in care across the region. A Call to Action is proposed to improve acute care, rehabilitation and secondary fracture prevention across Asia Pacific.

PURPOSE: Fragility fractures impose a substantial burden on older people and their families, healthcare systems and national economies. The current incidence of hip and other fragility fractures across the Asia Pacific region is enormous and set to escalate rapidly in the coming decades. This publication describes findings of a survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association (APOA) conducted in 2022.

METHODS: The survey was developed as a collaboration between the Asia Pacific Osteoporosis and Fragility Fracture Society and the Asia Pacific Fragility Fracture Alliance, and included questions relating to aspects of care upon presentation, during surgery and mobilisation, secondary fracture prevention, and access to specific services.

RESULTS: In total, 521 APOA members completed the survey and marked variation in delivery of care was evident. Notable findings included: Fifty-nine percent of respondents indicated that analgesia was routinely initiated in transit (by paramedics) or within 30 minutes of arrival in the Emergency Department. One-quarter of respondents stated that more than 80% of their patients underwent surgery within 48 hours of admission. One-third of respondents considered non-hip, non-vertebral fractures to merit assessment of future fracture risk. One-third of respondents reported the presence of an Orthogeriatric Service in their hospital, and less than a quarter reported the presence of a Fracture Liaison Service.

CONCLUSION: A Call to Action for all National Orthopaedic Associations affiliated with APOA is proposed to improve the care of fragility fracture patients across the region.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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