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El tiempo es hueso: oportunidades perdidas para la prevención secundaria después de una fractura de cadera

Ioannis I Daskalakis¹, Johannes D Bastian², Theodoros H Tosounidis¹

¹Department of Orthopaedic Surgery, Medical School, University Hospital of Heraklion, University of Crete, 71110 Heraklion, Greece.

Journal of clinical medicine

|August 28, 2025

Resumen

En los estudios de fracturas de cadera en pacientes de edad avanzada, rara vez se ha informado sobre el tratamiento de la osteoporosis, lo que pone de manifiesto una brecha en la prevención de fracturas secundarias. La mejora de los informes y la investigación son cruciales para mejorar los resultados de los pacientes.

Área de la Ciencia:

Medicina para la edad avanzada
Cirugía ortopédica
Salud pública

Sus antecedentes:

La prevención de fracturas secundarias es crítica después de las fracturas de cadera en los ancianos.
El tratamiento de la osteoporosis después de una fractura de cadera requiere una evaluación y tratamiento tempranos.
La documentación actual sobre el tratamiento de la osteoporosis en los estudios de fractura de cadera no es clara.

Objetivo del estudio:

Revisar y resumir sistemáticamente los informes sobre el tratamiento de la osteoporosis en estudios de fracturas de cadera tratadas quirúrgicamente en pacientes ancianos.
Identificar las lagunas en la documentación de las estrategias de prevención de fracturas secundarias.
Proporcionar recomendaciones para la práctica clínica y la investigación futura.

Principales métodos:

Revisión sistemática que se adhiere a las directrices de PRISMA.
Búsqueda exhaustiva de la literatura en las principales bases de datos (PubMed, Embase, Cochrane, Web of Science, Ovid) en la última década.
Inclusión de estudios sobre fracturas de cadera tratadas quirúrgicamente en pacientes mayores de 65 años, con evaluación independiente y extracción de datos por dos revisores.

Principales resultados:

Se incluyeron ochenta y seis artículos en la revisión.
La gestión de la osteoporosis se informó en sólo 12 (14%) de los estudios incluidos.
Sólo seis estudios (7%) provenían de instituciones con atención ortogeriátrica establecida.

Conclusiones:

El tratamiento de la osteoporosis está significativamente subreportado en los estudios de fracturas de cadera tratadas quirúrgicamente en personas mayores.
Esta falta de información indica una brecha sustancial en la documentación de los esfuerzos de prevención de fracturas secundarias.
Existe la necesidad de una mayor vigilancia clínica en el tratamiento de la osteoporosis posterior a la fractura de cadera y de una investigación centrada en la eficacia de las estrategias de prevención secundaria.

Palabras clave:

densidad ósea fractura de cadera La osteoporosis Prevención secundaria de la enfermedad procedimientos quirúrgicos análisis sistemático

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