1. Overview
Geriatric fragility fractures are a significant public health concern due to their impact on morbidity, mortality, and healthcare costs. As the global population continues to age, there is a growing need for effective strategies to prevent and manage these fractures in elderly.
Service gaps in the geriatric fragility fracture care provision were well studied and recognized. Over the decades, multi-disciplinary health care professionals in Hong Kong contributed tremendously towards a systemic and comprehensive service model. with implementation of Key Performance index (KPI), enhanced timely intervention through designated fragility fracture surgery provision, Ortho-Geriatric collaborative care journey, Fracture Liaison Service, restorative and seamless rehabilitation from hospital to community, primary and secondary prevention by optimizing bone health & fall prevention.
Literatures have proven the value of early surgery is associated with reduced mortality and perioperative complications. Patients operated on within 48 hours had a 20% lower 1-year mortality. Though such KPI improved significantly in Hong Kong over the last 20 years, it is still a challenging mission which requires multidisciplinary collaboration and the availability of sufficient surgical capacity with competent teams and facilities support. Moreover, the longer life expectancies in Hong Kong indicated a high association of complex comorbidities in elderly demand a higher quality of peri-operative care for risk mitigation.
Huge volume of fragility fracture service load provides treasurable opportunity for the establishment of Hip fracture registry and electronic platform. Relevant Smart initiatives and the big data pool will certainly become a powerful tool for service improvement. A domestic Artificial Intelligence Hip fracture diagnosis assistance already developed and in use in local hospitals.
The extended post-discharge journey to primary medical care and community rehabilitation, in particular the new service model of District Health Center (DHC), are sustainable strategies to optimize the achievable functional recovery.
