Best Practices for Management of Fractures in Spinal Cord Injuries and Disorders

骨质疏松相关骨折是脊髓损伤(SCI)患者的一个严重问题。然而，最好的 这些骨折的急诊护理的管理，包括是否应该手术治疗与非手术治疗 已经完成，影响这一决定的因素尚不清楚。这一点得到了供应商的很好理解，他们 已经向SCI QUERI确认了建立治疗高血压患者骨折的最佳实践的研究 脊髓损伤应该是一个优先领域。外科手术治疗下肢骨折的频率比 以前报道过，现在大约有10%-37%的骨折是通过手术治疗的。然而， 影响选择手术与非手术治疗骨折的因素以及手术与非手术治疗的结果 治疗方法还没有被描述。在本提案中，我们将使用半结构化的管理数据库 问卷和案例情景，并召集一个杰出的咨询小组审查这些信息和 现有文献开始了解脊髓损伤中骨质疏松性骨折的最佳治疗方法。 我们将包括患者和提供者(整形外科医生和PM&R医生)在调查中。这 该建议对不断扩大的脊髓损伤患者群体具有直接、直接的潜在临床益处。会的 为提供者提供宝贵信息，以便在这些患者持续接受治疗时更好地护理他们 骨质疏松性骨折。

Osteoporotic-related fractures are a serious problem for patients with Spinal Cord Injury (SCI). However, best management for acute care of these fractures including whether surgical vs. nonsurgical treatment should be done and the factors that influence this decision is not known. This point is well appreciate by providers, who have identified to SCI QUERI that research to establish best practices for treatment of fractures in patients with a SCI should be a priority area. Surgical treatment for lower extremity fractures is done more frequently than previously reported, with approximately 10-37% of these fractures now managed surgically. However, the factors that influence the choice of surgical vs. nonsurgical fracture treatments and outcomes following these therapies have not been described. In this proposal we will utilize administrative databases, semi-structured questionnaires and case scenarios, and convene an outstanding advisory panel to review this information and existing literature to start the process of understanding best management for osteoporotic fractures in SCI. We will include both patients and providers (orthopedic surgeons and PM&R physicians) in the surveys. This proposal is of direct, immediate potential clinical benefit to the expanding population of patients with SCI. It will provide invaluable information for providers to better be able to care for these patients when they sustain an osteoporotic fracture.