Tough Break

Dr. Shkolnik-Tripto: “Every year around 300 patients are admitted to Hillel Yaffe with hip fractures"

The Endocrinology Unit at Hillel Yaffe Medical Center, in collaboration with the orthopedic departments, is offering a new service aimed at identifying patients who suffer from osteoporosis and its consequences, but who are unaware of the disease. The goal: timely detection and proper assistance in recovery after fracture surgery.

The new service is part of the unit’s Osteoporosis Clinic, managed by Dr. Leanna Shkolnik-Tripto, senior physician in the unit. The clinic’s services include monitoring and treatment for sufferers of osteoporosis and patients with fractures. New services include early identification of patients who are unaware they have osteoporosis. Such early detection will facilitate treatment of the disease and prevention of additional fractures and associated complications in the future.

What is osteoporosis?

Osteoporosis is a condition in which bone depletion occurs (the word osteoporosis means "bone with holes"), but in fact, the main risk of the disease is the formation of a fracture. It is a disease created by the diminishment of bone quantity, damage to its quality and as a result of these, significant bone weakness and the likelihood of breaks due to falls. It is important to know that the disease is rather "quiet," meaning the person is usually unaware of it unless tests are performed, or in the worst case, a bone breaks.

And yet, U.S. statistics show that one of every two women over 50 may experience a fracture as a result of osteoporosis in her lifetime. And one in every five men in the same age group may suffer an osteoporetic crisis.

Why can early detection save lives?

"Every year about 300 patients with hip fractures are admitted to Hillel Yaffe," said Dr. Shkolnik-Tripto, “aside from the fact that it is not a simple operation, recovery is complicated, and the risk of mortality in the first year following the fracture is about 20-25%. From my point of view, the problem is the fact that only 20% of patients with fractures over the age of 50 also receive comprehensive rehabilitative care, including diagnosis of osteoporosis. Many patients and many caregivers or family physicians do not associate the fall and fracture with the possibility of osteoporosis, and then, even if the patient undergoes rehabilitation, the source of the problem, i.e., bone loss and weakness, is not treated at all, increasing the likelihood of fracture in the future."

How does the system work?

"First of all," explains Dr. Tripto, "in cooperation with our Orthopedics Department, we identify older patients who underwent surgery for a fracture or other fracture treatment. Each day, the unit’s secretary reviews all medical records. She was trained, with my assistance, to identify the patients who meet the risk criteria. The secretary sends these people a letter inviting them to come to our clinic for diagnosis by an endocrinologist.

"Secondly, we try to heighten awareness among our medical staff and community physicians about the need for consultation with an endocrinologist following fracture surgery, to provide comprehensive care for the patient - rehabilitation of the affected area as well as drug therapy that includes physical therapy to treat the cause of the original fracture.

"Another possible course of action, which we try to encourage in the Endocrinology Unit, is to heighten awareness of adults aged 50 or older. We encourage them to ask their family physician to be tested, with the aim of prevention. We also bring the need for the test to the attention of the families of elderly hospital patients.

"It is important to understand," observed Dr. Tripto, "that is quite possible to tailor drug therapy for osteoporosis among seniors, too, after the injury has occurred. Certain drugs have been tested for the elderly and have been found to be appropriate and correct. Medication has also been shown to cut fracture risk in half."

* Diagnostic services and counseling for the disease are currently available in the clinic in the Endocrinology Unit. For more information and to schedule an appointment, contact Endocrinology at 04-6304748. Referrals from both the family physician and the patient’s health fund are required.