Title : "Hip hip hooray”: Adequate bone protection for patients with hip fractures
Abstract:
Background: Managing acute hip fractures involves preventing their recurrence, which is crucial. This is because fragility fractures can elevate the likelihood of subsequent fractures, with as many as 11% of patients experiencing a second fracture within the first year. It has been extensively researched and proven that the use of bisphosphonates can reduce the recurrence rate by a significant 36%. The aim is to ensure that patients with hip fractures receive appropriate investigations and management for bone health in a timely fashion.
Methods: This retrospective project involved all patients admitted to a district General Hospital with traumatic femur and peri-prosthetic fractures between 01/11/2022 and 01/03/2023. All patient demographics, investigations and management data were collected electronically using eTrauma, System C (care flow) and clinical notes.
Results: From a total of 105 patients, only 26% of patients had a Bone profile, 6% had B12 and folate, and 5% had vitamin D levels checked on admission. Thus, if clinically indicated, only 67% of patients received high dose vitamin D, with the median for starting intervention being 6th of admission. 26% of patients received Bone protection.
Conclusions: It's concerning that 75% of patients with hip fractures aren't receiving the required investigations and treatment for Bone Protection, which is critical in preventing more fractures. We need to take prompt action to create and release an internal protocol to guarantee that these patients receive the necessary care. Additionally, we need to prescribe adequate analgesia upon admission.
