of the Femoral Shaft and Patella的股骨和髌骨骨折课件.ppt

Bisphosphonates Bisphosphonates are bone-building drugs that prevent bone resorption and remain important treatment options for patients at risk of debilitating fractures. But, where does the impact on dental health figure into the equation? What is the true incidence of osteonecrosis of the jaw (ONJ)? Source: Bamias A. Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: incidence and risk factors. J Clin Oncol 2005;23(34):8580-7. Approximately 125 cases of osteonecrosis have been linked to bisphosphonate usage. The majority of these cases have been administered through an IV to cancer patients The Facts A man with a hip fracture has a 1:3 chance of dying within a year A woman with a hip fracture has a 1:4 chance of dying within a year The risk for ONJ among patients taking oral bisphosphonates is likely to be 1:100,000 Bisphosphonates Bisphosphonate Associated Fracture May occur with long term bisphosphonate use Relatively rare occurrence compared to fragility fractures Risk/benefit analysis still favors bisphosphonate use Source: Bisphosphonate use and the risk of subtrochanteric or femoral shaft fractures in older women. Park-Wyllie LY, Mamdani MM, Juurlink DN, Hawker GA, Gunraj N, Austin PC, Whelan DB, Weiler PJ, Laupacis A. JAMA. 2011 Feb 23;305(8):783-9. 7. Patient Note Provide the patient with written information regarding fragility fractures and preventive measures that can be taken. Encourage them to speak with their primary care physicians for additional follow-up after the fracture has healed Treatment 8. Physician Referral A letter sent to the primary care physician can provide information regarding the patient’s fracture and recommend appropriate measures be taken Treatment Use handrails on stairs, bathroom Keep rooms free of clutter Keep floors clean but not slippery Wear supportive, low-heeled shoes. Don’t walk in socks; floppy slippers Use 100 watt bulbs in all rooms Install ceiling lighting in bedrooms Use