ITALIAN PERSPECTIVE

Abstract

The new S.I.C.O. (Italian Society for Surgery of Osteoporosis) is trying to establish a register for osteoporotic complications, namely for Hip fractures, in fact at the moment only limited epidemiological data are available about the incidence of hip fractures in Italy. These data vary widely across the Italian Regions.

In the last five years E.S.O.P.O. study allowed us to have epidemiological data about osteoporosis in Italy, and from then a group of Orthopedic Units, distributed along all the country, are collecting data to better understand the epidemiological relevance of Hip Fractures.

84.188 Hip fractures were registered in 2001 from the Italian Ministry of health, which meant 1.48 fracture every 1.000 citizen, 25% of which were males.

From some areas through relating fractures and age was possible to establish that there were 3.7 fractures every 1.000 people over 50 years of age, 4.5 fractures every 1.000 females over 50 years of age, 1.9 every 1.000 males over 50.

From the Units working at the project few significant data were obtained: mean time between hospital arrival and surgery was 3.9 days, considered very high, the mean time of Hospital stay was 9.5 days for all patients, but 14.5 days for patients that underwent to an operation.

55% were lateral fractures for which a new “Italian” undersized titanium nail was introduced in February 2003, which rapidly was adopted in many hospital for its simplicity and low cost.

Controversial among Orthopedic surgeons arose because some of them are treating lateral fractures with total or partial hip replacement.

Because of different health organization between Regions of North, Center and South of Italy the patients are discharged to rehabilitation Unit mainly in North of Italy, less in Southern part where for a lack of Rehabilitation Units, most of the patients go back home, supported from public health operators at their family place.