Clinical Research Directory

Application and Effect of "Internet + Nursing" in Hip Fragility Fracture Patients Based on Fracture Liaison Service

Fragility fractures, also known as osteoporotic fractures, are fractures that occur as a result of low-energy trauma or minor impact. They are the most serious complication of osteoporosis and are common bone diseases in the elderly. With our country gradually entering the aging society, the incidence of brittle fracture is increasing year by year, most often in the hip. Hip fracture refers to femoral neck, intertrochanteric and subtrochanteric fractures. Due to a series of complications caused by old age, weak body, many underlying diseases, significant decline in self-care ability and other reasons, it is also known as the last fracture in life. According to reports, within 1 year after hip fracture, only 30% of patients can recover to the functional state before fracture, 20% of patients will fracture again, and even cause lifelong disability, seriously affecting the long-term quality of life of patients, the reason may be related to the long course of disease, slow recovery, postoperative nutrition, rehabilitation exercise compliance, self-care ability decline and many other aspects. The fracture liaison service (FLS) is a nurse-centric, multidisciplinary approach to managing osteoporotic fractures that consists of three key elements: The core of identifying patients with fracture risk, assessing fall risk and initiating treatment to prevent refracture is to hire specialized coordinators to link emergency, orthopedics, rehabilitation, nutrition and other departments with community and family services to provide standardized management services for patients, reduce the incidence of refracture and promote the recovery of joint function of patients. Therefore, this study integrates FLS with "Internet + nursing service" and utilizes the advantages of "Internet + nursing service" in informatization to emphasize the risk assessment of re-fracture of patients at home after discharge, home health guidance (such as fall prevention, rehabilitation training and other related knowledge), online consultation of multidisciplinary teams, offline on-site service, etc., so that patients can be discharged from hospital. Access to ongoing medical care reduces the incidence of complications and promotes rapid recovery.

Incidence of Fragility Fractures and Osteoporosis Screening in Chronic Stroke Patients

Stroke is a known risk factor for the development of osteoporosis, leading to an increased risk of falls and fractures. Several international studies have associated stroke with hip fractures, showing an odds ratio ranging between 1.5 and 4. The literature frequently indicates a lack of management for bone metabolism in patients following cerebrovascular events. This study aims to evaluate the incidence of osteoporosis and fragility fractures in patients with chronic stroke. A secondary aim is to assess whether patients have been adequately screened for bone metabolism following a cerebrovascular event. This study is designed as a prospective observational study. Patients aged over 65 years with chronic stroke are assessed at the U.O.C. of "Functional Recovery and Rehabilitation" at A.O.U.P. "P. Giaccone," Palermo. During the assessment, clinical and demographic data are collected, including details of the cerebrovascular event (location, hemorrhagic/ischemic, date), pre-event and post-event disability/autonomy (Rankin scale), presence of fractures (location and date) in the patient's medical history (pre and post-event), femoral and lumbar DEXA for osteoporosis evaluation, and DeFRA for assessing the 10-year risk of fragility fractures.