Zeitschrift für Gerontologie und Geriatrie

, Volume 51, Issue 1, pp 113–125 | Cite as

Management der Osteoporose nach Fragilitätsfrakturen

  • M. Gosch
  • U. Stumpf
  • C. Kammerlander
  • W. Böcker
  • H. J. Heppner
  • S. Wicklein
CME
  • 144 Downloads

Zusammenfassung

Osteoporose ist eine systemische Knochenerkrankung, die durch verminderte Knochenfestigkeit zum erhöhten Frakturrisiko prädisponiert. Gerade bei alten Personen besteht ein hohes Frakturrisiko, häufig bereits als Folge eines inadäquaten Traumas. Verletzungen dieser Art werden als Fragilitätsfrakturen bezeichnet. Ihre rasche chirurgische Versorgung und die nachfolgende frühzeitige Mobilisierung sind zum Standard der Frakturbehandlung im Alter geworden. Die Therapie der zugrunde liegenden Osteoporose tritt häufig in den Hintergrund der Akutversorgung. Nur ein kleiner Anteil der Patienten ist vortherapiert; nur wenige Patienten erhalten nach erlittener osteoporotischer Fraktur eine umfassende osteologische Medikation, die die Progredienz der Osteoporose mindert und das Eintreten weiterer Frakturen reduziert („osteoporosis care gap“). Der vorliegende Beitrag gibt einen Überblick über die Therapiemöglichkeiten und beantwortet zahlreiche Fragestellungen aus dem klinischen Alltag.

Schlüsselwörter

Alterstraumatologie Bisphosphonate Denosumab Lücken in der Versorgungspraxis Therapieversagen 

Management of osteoporosis after fragility fractures

Abstract

Osteoporosis is defined as a systemic bone disease with decreased bone strength and an increased susceptibility for fractures. Older people in particular face an increased risk of fractures. These kind of fractures are usually caused by an inadequate trauma and are the so-called fragility fractures. In older adults immediate fracture stabilization and early mobilization have become the standard procedure after a fragility fracture. Treatment of the underlying osteoporosis often plays a minor role in clinical practice. Only a small group of patients are already under osteoporosis medication and even after a fracture occurs only few patients receive osteoporosis drug treatment with the aim to reduce the progression of osteoporosis and to reduce subsequent fractures. In the literature this has been described as the osteoporosis care gap. The following article presents an overview of treatment options and answers many different questions from the clinical routine.

Keywords

Orthogeriatrics Diphosphonates Denosumab Practice gap Therapy failure 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Gosch und W. Böcker erhielten Vortragshonorare von Amgen und Lilly, C. Kammerlander von Lilly und Depuy Synthes, H.J. Heppner von Pfizer Deutschland, Bayer Healthcare und Astellas Pharma. U. Stumpf erhielten Vortragshonorare von Amgen und Lilly und war an klinischen Studien (Amgen) beteiligt. S. Wicklein gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Universitätsklinik für Geriatrie, Medizinische Klinik 2 – Schwerpunkt Geriatrie, Klinikum NürnbergParacelsus Medizinische Privatuniversität, Campus NürnbergNürnbergDeutschland
  2. 2.Klinik für Allgemeine, Unfall- und WiederherstellungschirurgieKlinikum der LMUMünchenDeutschland
  3. 3.Universitätsklinik für UnfallchirurgieMedizinische Universität InnsbruckInnsbruckDeutschland
  4. 4.Klinik für GeriatrieHELIOS Klinikum SchwelmSchwelmDeutschland
  5. 5.Lehrstuhl für GeriatrieUniversität Witten/HerdeckeWitten/HerdeckeDeutschland

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