Orthogeriatrics : : The Management of Older Patients with Fragility Fractures.

• Superior document: Practical Issues in Geriatrics Series
• Author: Falaschi, Paolo.
• TeilnehmendeR: Marsh, David.
• Place / Publishing House: Cham : : Springer International Publishing AG,, 2020.; ©2021.
• Year of Publication: 2020
• Edition: 2nd ed.
• Language: English
• Series: Practical Issues in Geriatrics Series
• Physical Description: 1 online resource (355 pages)

Table of Contents

• Intro
• Preface to the Second Edition
• Contents
• Part I: Background
• 1: The Multidisciplinary Approach to Fragility Fractures Around the World: An Overview
• 1.1 Introduction
• 1.2 General Developments Since 2016
• 1.2.1 The Global Call to Action
• 1.2.2 The Formation of National FFNs
• 1.2.3 Initiation of New Hip Fracture Registries
• 1.2.4 Implications of These General Developments for the Design of This Second Edition
• 1.3 Background: Chaps. 2-4
• 1.3.1 Epidemiology of Fractures and Social Costs: Chap. 2
• 1.3.2 Osteoporosis in Older Patients: Chap. 3
• 1.3.3 Frailty and Sarcopenia: Chap. 4
• 1.4 Pillar I: Co-Management in the Acute Episode-Chaps. 5-11
• 1.4.1 Establishing an Orthogeriatric Service: Chap. 5
• 1.4.2 Pre-hospital Care and the Emergency Department: Chap. 6
• 1.4.3 Perioperative Orthogeriatric Care: Chaps. 7 and 11
• 1.4.4 Orthogeriatric Anaesthesia: Chap. 8
• 1.4.5 Hip Fracture: The Choice of Surgery-Chap. 9
• 1.4.6 Proximal Humeral Fractures: The Choice of Treatment-Chap. 10
• 1.5 Pillar II: Rehabilitation-Chaps. 12 and 13
• 1.5.1 Rehabilitation Following Hip Fracture: Chap. 12
• 1.5.2 The Psychological Health of Patients and Their Caregivers: Chap. 13
• 1.6 Pillar III: Secondary Prevention-Chaps. 14-16
• 1.6.1 Fracture Liaison Services: Chap. 14
• 1.6.2 Current and Emerging Treatment of Osteoporosis: Chap. 15
• 1.6.3 How Can We Prevent Falls?-Chap. 16
• 1.7 Cross-Cutting Issues: Chaps. 17-19
• 1.7.1 Nursing in the Orthogeriatric Setting: Chap. 17
• 1.7.2 Nutritional Care of the Older Patient with Fragility Fracture: Chap. 18
• 1.7.3 Fragility Fracture Audit: Chap. 19
• 1.8 Concluding Remarks
• References
• 2: Epidemiology of Fragility Fractures and Social Impact
• 2.1 Introduction
• 2.2 Prevalence of Osteoporosis.
• 2.3 Factors Affecting Bone Mineral Density
• 2.4 Osteosarcopenia
• 2.5 Falls
• 2.6 Incidence of Fragility Fractures
• 2.7 Hip Fracture
• 2.8 Other Osteoporotic Fractures
• 2.9 The Burden of Fragility Fractures
• 2.10 The Costs and Social Impact of Hip Fracture
• 2.11 The Costs and Social Impact of Other Osteoporotic Fractures
• 2.12 Conclusions
• References
• 3: Osteoporosis and Fragility in Elderly Patients
• 3.1 Definition
• 3.2 Epidemiology
• 3.3 The Anatomy of Bone
• 3.4 The Physiology of Bone
• 3.5 Pathogenesis
• 3.6 Risk Factors for Fragility Fractures
• 3.6.1 BMD
• 3.6.2 Age
• 3.6.3 Previous Fractures
• 3.6.4 Family History of Fracture
• 3.6.5 Comorbidities
• 3.6.6 Drugs
• 3.6.7 Assessment of Fracture Risk
• 3.7 Diagnosis
• 3.7.1 Instrumental Diagnosis
• 3.7.1.1 Dual X-Ray Absorptiometry (DXA)
• 3.7.1.2 Quantitative Computerised Tomography (QCT)
• 3.7.1.3 Quantitative Ultra-Sound (QUS)
• 3.7.2 X-Ray of the Dorsal and Lumbar Spine
• 3.7.3 Laboratory Tests
• 3.8 Management of Osteoporosis
• 3.8.1 Lifestyle Modification
• 3.8.1.1 Prevention of Falls
• 3.9 The Importance of Vitamin D, Calcium and Protein Intake
• 3.9.1 Vitamin D
• 3.9.2 Calcium
• 3.9.3 Protein
• 3.10 Therapeutic Adherence in Osteoporosis and the Role of Health Professionals
• References
• 4: Frailty and Sarcopenia
• 4.1 Frailty
• 4.1.1 The Nature of Frailty
• 4.1.2 Epidemiology of Frailty
• 4.1.3 How Does Frailty Develop?
• 4.1.4 Assessment of Frailty in Clinical Practice
• 4.1.5 Incorporating Frailty into Treatment Plans and Service Design
• 4.2 Sarcopenia
• 4.2.1 The Nature of Sarcopenia
• 4.2.2 Epidemiology
• 4.2.3 How Does Sarcopenia Develop?
• 4.2.4 Assessing Sarcopenia in Clinical Practice
• 4.2.5 Incorporating Sarcopenia into Treatment Plans and Service Design.
• 4.3 The Implications of Frailty and Sarcopenia on Falls, Fractures and the Recovery After Fractures
• 4.4 Concluding Statement
• References
• Part II: Pillar I: Co-management in the Acute Episode
• 5: Establishing an Orthogeriatric Service
• 5.1 Introduction
• 5.2 Designing the Orthogeriatric Service
• 5.2.1 Step 1: Process Mapping the Hip Fracture Pathway
• 5.2.2 Step 2: Identify a Core Multidisciplinary Team and Form a Steering Group
• 5.2.3 Step 3: Analyse and Review the Patient Pathway
• 5.2.4 Step 4: Evaluate the Resources Required to Drive Change Within the Organisation
• 5.2.5 Step 5: Develop the Business Case for the Orthogeriatric Service
• 5.2.6 Step 6: Implementing and Sustaining the Service
• 5.2.7 Step 7: Collect Evidence of Service Improvement: Audit
• 5.2.8 Step 8: Embrace the Support of Regional, National and International Organisations
• 5.3 Conclusion
• References
• 6: Pre-hospital Care and the Emergency Department
• 6.1 Pre-hospital Care
• 6.1.1 Clinical Assessment: Primary Survey
• 6.1.2 Clinical Assessment: Secondary Survey
• 6.1.3 Patient History
• 6.1.4 Physical Assessment and Vital Signs
• 6.1.5 Management of Pain
• 6.1.6 Fluid Replacement
• 6.1.7 Extrication
• 6.1.8 Transportation
• 6.2 The Emergency Department
• 6.2.1 Nutrition and Hydration
• 6.2.2 Management of Pain
• 6.2.3 Ongoing Analgesia
• 6.2.4 Local Nerve Blocks
• 6.2.5 Skin Care
• 6.2.6 Referral for Early Surgery
• 6.3 Summary
• References
• 7: Pre-operative Medical Assessment and Optimisation
• 7.1 Pre-operative Medical Assessment
• 7.2 Information Gathering
• 7.3 Cardiovascular Disease
• 7.3.1 Valvular Heart Disease
• 7.3.2 Heart Failure
• 7.3.3 Conduction Defects, Pacemakers and Implantable Cardiac Defibrillators (ICD)
• 7.3.4 Atrial Fibrillation (AF).
• 7.4 Management of Anticoagulants and Anti-platelets
• 7.5 Anaemia
• 7.6 Diabetes
• 7.7 Chronic Kidney Disease (CKD)
• 7.8 Respiratory Disease
• 7.9 Medication Review
• 7.10 Preventing Complications: Thromboembolic Events
• 7.11 Antibiotic Prophylaxis
• 7.12 Appropriate Ceilings of Care
• 7.13 Conclusion
• References
• 8: Orthogeriatric Anaesthesia
• 8.1 Introduction
• 8.2 The Relationship Between Anaesthetist and Orthogeriatrician
• 8.3 Preoperative Care
• 8.3.1 Preoperative Analgesia
• 8.3.2 Preoperative Preparation
• 8.3.3 Ethical and Legal Considerations
• 8.4 Intraoperative Care
• 8.4.1 General or Spinal Anaesthesia?
• 8.4.2 Peripheral Nerve Block
• 8.4.3 Spinal Anaesthesia
• 8.4.4 Sedation
• 8.4.5 General Anaesthesia
• 8.4.6 Avoiding Ischaemia
• 8.4.7 Bone Cement Implantation Syndrome (BCIS)
• 8.4.8 Standardisation of Anaesthesia
• 8.5 Postoperative Care
• References
• 9: Hip Fracture: The Choice of Surgery
• 9.1 Aim of Surgery
• 9.2 Fracture Types
• 9.2.1 Intra-capsular Fracture Types
• 9.2.2 Extra-capsular Fracture Types
• 9.3 Implants
• 9.4 Surgical Management
• 9.4.1 Intra-capsular Operations
• 9.4.2 Extra-capsular Operations
• 9.5 Surgical Algorithms and National Guidelines
• References
• 10: Proximal Humeral Fractures: The Choice of Treatment
• 10.1 Aim of Treatment
• 10.2 Evidence and Literature
• 10.3 Epidemiology
• 10.4 Fracture Classification
• 10.4.1 Minimally Displaced Fractures
• 10.4.2 Displaced Fractures
• 10.5 Treatment
• 10.5.1 Non-surgical Treatment
• 10.5.2 Surgical Management
• 10.6 Complications
• 10.7 Outcome Assessment
• 10.8 Conclusions
• References
• 11: Post-operative Management
• 11.1 Multidisciplinary Management
• 11.2 Predicting the Risk of Post-operative Complications
• 11.3 Early Mobilisation.
• 11.4 Pain Management
• 11.5 Post-operative Hypotension and Fluid Management
• 11.6 Management of Postsurgical Anaemia
• 11.7 Nutritional Supplementation
• 11.8 Post-operative Medical Complications
• 11.9 Prevention and Management of Specific Complications
• 11.9.1 Delirium
• 11.9.1.1 Prevention of Post-operative Delirium
• 11.9.1.2 Management of Post-operative Delirium
• 11.9.1.3 Post-operative Cognitive Dysfunction
• 11.9.2 Cardiovascular Complications
• 11.9.2.1 Myocardial Infarction
• 11.9.2.2 Heart Failure
• 11.9.2.3 Supraventricular Arrhythmias
• 11.9.3 Infections
• 11.9.3.1 Post-operative Fever
• 11.9.3.2 Pneumonia
• 11.9.3.3 Urinary Tract Infection
• 11.9.3.4 Surgical Site Infection
• 11.9.4 Other Complications
• 11.9.4.1 Acute Kidney Injury (AKI)
• 11.9.4.2 Gastrointestinal Complications
• 11.9.4.3 Pressure Ulcers
• 11.10 Final Remarks
• References
• Part III: Pillar II: Rehabilitation
• 12: Rehabilitation Following Hip Fracture
• 12.1 The Need for Increased Provision of Rehabilitation Worldwide
• 12.2 The Principles of Rehabilitation Programmes after Hip Fracture
• 12.3 What Is Known about the Pattern of Recovery Following Hip Fracture?
• 12.4 Factors Associated with Poor Outcomes After Hip Fracture
• 12.5 Key Elements of a Rehabilitation Pathway
• 12.6 What Programmes Should We Recommend to Help with Recovery?
• 12.6.1 In-hospital Rehabilitation
• 12.6.2 Rehabilitation in the Community
• 12.6.3 Rehabilitation in Low Resource Settings
• 12.7 Rehabilitation and Cognitive Impairment
• 12.7.1 Enhanced Interdisciplinary Inpatient Rehabilitation and Care
• 12.7.2 Enhanced Interdisciplinary Inpatient and Home-Based Rehabilitation
• 12.8 Psychosocial Factors and Rehabilitation
• 12.9 Delivery of Rehabilitation Following Hip Fracture in LMICs.
• 12.9.1 Key Evidence-Based Recommendations and Their Implementation in LMICs.