BEST PRACTICES FOR MANAGEMENT OF FRACTURES IN SPINAL CORD INJURIES AND DISORDERS

Osteoporotic-related fractures are a serious problem for patients with Spinal Cord Injury (SCI). However, bestmanagement for acute care of these fractures including whether surgical vs. nonsurgical treatment should bedone and the factors that influence this decision is not known. This point is well appreciate by providers, whohave identified to SCI QUERI that research to establish best practices for treatment of fractures in patients witha SCI should be a priority area. Surgical treatment for lower extremity fractures is done more frequently thanpreviously reported, with approximately 10-37% of these fractures now managed surgically. However, thefactors that influence the choice of surgical vs. nonsurgical fracture treatments and outcomes following thesetherapies have not been described. In this proposal we will utilize administrative databases, semi-structuredquestionnaires and case scenarios, and convene an outstanding advisory panel to review this information andexisting literature to start the process of understanding best management for osteoporotic fractures in SCI.We will include both patients and providers (orthopedic surgeons and PM&R physicians) in the surveys. Thisproposal is of direct, immediate potential clinical benefit to the expanding population of patients with SCI. It willprovide invaluable information for providers to better be able to care for these patients when they sustain anosteoporotic fracture.