Abstract
Introduction
In The UK around 519,000 new fragility fractures occur each year, with vertebral compression fractures among the most common1. Around 21% of vertebral fractures are incidentally found on radiological imaging2. Within Aneurin Bevan University Health Board (ABUHB) there is no formal pathway for managing incidental vertebral fractures identified on radiological imaging.
Objective
To retrospectively quantify the burden of incidental vertebral fractures and their subsequent management across a large UK Health Board. Method Patients with incidental fractures on CT scans were identified between 1st August 2020 to 1st February 2021 at ABUHB. Exclusion criteria included fractures secondary to malignancy or major trauma and death within 2 years. A pathway for management of new incidental vertebral fractures was devised and was introduced to one Care of the Elderly ward at the Royal Gwent Hospital. Results 233 patients with incidental fragility vertebral fractures were identified. 60% (139/233) were deceased and excluded. Of the patients included in the study 29% (27/94) were previously on bone protection, 19% (18/94) were commenced on bone protection, 47% (44/94) were commenced on Vitamin D, 38% (36/94) were commenced on Calcium, 12% (11/94) had a DEXA scan arranged and 17% (16/94) had orthogeriatric follow up. Care of the Elderly specialty noted the greatest burden at 40% (37/94).
Conclusion
Results indicate a significant mortality associate with osteoporotic fractures. Continuing development of the pathway for management of incidental fragility fractures and expansion throughout the health board may result in sustained improvement. 1. Borgström F, Karlsson L, Ortsäter G, et al. Fragility fractures in Europe: burden, management and opportunities. Archives of Osteoporosis 2020; 15(1): 59. 2. Bartalena, T., 2010. Incidental vertebral compression fractures in imaging studies: Lessons not learned by radiologists. World Journal of Radiology, 2(10), p.399.