Fragility Fracture Systems: International Perspectives - Asia & Australia

Abstract

Background: The incidence and burden of fragility fractures have reached the level where comprehensive systematic care is warranted to optimize the care of these patients. Hip fractures are the most frequently lethal and independence level changing fragility fractures, responsible for 30-day mortality comparable to high-energy trauma patients with injury severity scores over 12. It is a reasonable expectation that countries have a hip fracture treating system of care in place for this high-risk population. This review explores the systems of care from the Asia-Pacific Perspective.Methods: From the International Orthopaedic Trauma Association's member societies, nations from the Asia-Pacific Region were requested to contribute with an overview of their fragility fracture management systems. The content or the review was standardized by a template of headings, which each country endeavored to cover.Results: Australia, Japan, and South Korea contributed voluntarily from the 5 member countries of the region. Each country has made considerable efforts and achievements with diverse approaches to standardize and improve the care of fragility fractures, particularly hip fractures. Beyond the individual nations' efforts there is also an existing Asia-Pacific Collaborative. The data collection and in some counties the existence of a registry is promising; funding and recognition of the problem among competing health care budget priorities are common.Conclusions: Our review covers some of the countries with strongest economy and highest health care standards. The lack of a universal robust system for hip fracture care is apparent. The data collection from registry initiations is expected to drive system development further in these countries and hopefully fast track the development in other countries within the most populous geographical region of the Earth.

Current consensus and clinical approach to fragility fractures of the pelvis: an international survey of expert opinion

“…This results in practice variation and potentially suboptimal quality of care for patients with FFP, and therefore, this heterogeneity needs to be addressed internationally. 18 The lack of local, regional, or national guidelines is potentially the consequence of previous and historical underestimation of the significant impact of FFP. The relatively recent recognition in the past 5 to 10 years that FFP are a distinct entity that needs to be managed differently compared with other pelvic fractures, and the consequent relatively scarce high-quality evidence on the best management, obviates the need for further research and the development of an international evidence-based guideline.…”