How can we best prepare for the wave of fragility fractures that may accompany increasing life expectancy worldwide?

Understanding hip fractures: Going beyond Europe and North America
 
 By Dr James Masters, University of Oxford & Dr Maritz Laubscher, University of Cape Town
 
A fracture around the hip joint is typical in patients with frail bones. Hip fractures are a major cause of pain, disability and death in elderly people. Those affected often have multiple medical co-morbidities and complex care needs. Governments are beginning to recognise the costs of hip fractures to both individuals and society.
 
Work in Europe and North America informs our understanding of disease burden and treatment. One such study is the World Hip Trauma Evaluation (WHiTE) study run by Oxford University. This cohort study looks at care across the UK from admission to discharge. It has yielded significant insights into the effect of hip fracture on patients and carers. It also embeds randomised controlled trials of treatment from admission to discharge.
 
However it is unclear how relevant work like this may be to countries with different patient populations, mechanisms of injury and resources.
 
To explore this, the Oxford Trauma group are working with the Orthopaedic Research Unit (ORU) at the University of Cape Town. The ORU is based at Groote Schuur Hospital which is one of the two major hospitals serving South Africa's Western Cape. A research team from Oxford spent two months in Cape Town developing the collaboration. This included interviewing clinicians, patients and research staff. A small feasibility study was also conducted during this period to explore whether patients would be willing to take part and provide follow up data. The results of which should be available in summer 2019.
 
This collaboration is a first effort to explore how care models from high income countries might be used in different settings. The Oxford team will return to Cape Town in 2019 to continue this work. We hope that collaborative working can ensure that patients across the world benefit from high quality research wherever it may originate.
 
Find out more:
http://bmjopen.bmj.com/content/6/10/e011679.info
http://www.oru.uct.ac.za
@Oxford_Trauma

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