“Registry-based data is quickly becoming the standard for surgeons to document and demonstrate their patient outcomes and standardized reporting for quality orthopaedic care,” said Michael J. Gardner, MD, FAAOS, chair of the AAOS FTR Steering Committee. “Collecting and utilizing registry data has been pivotal for joint replacement, is on track for spine surgery, and will soon be for fractures. In the future, we hope patients can look for their surgeon not only to be a member of the AAOS, but also a participant in the Fracture & Trauma Registry. Together this will demonstrate a surgeon’s commitment to benchmarking and providing high-quality care.”

Fracture Risk with Advancing Age
Skeletal fragility, in combination with a greater propensity to fall, results in an increased susceptibility to fractures with aging. According to the Burden of Musculoskeletal Diseases in the United States, there are 1.5 to 2 million fractures in the United States annually[1]. Age-related fractures are projected to increase nationally from 2.1 million in 2005 to over 3 million fractures in 2025[2]. Hip fractures are most strongly associated with adverse consequences, but account for only a minority of fragility fractures. In many cases, treatment for fracture incidence involves a combination of immobilization, physical therapy, and surgery.

Expanding the AAOS Registry Program
The AAOS is the world’s largest medical association of musculoskeletal specialists. Trauma contributes to a large portion of orthopaedic conditions and procedures. The FTR will be the fifth in a series of anatomical, evidence-based registries that are part of the AAOS Registry Program, each designed to utilize data for making critical clinical and resource-related decisions to improve quality of care for patients. The other registries include the American Joint Replacement Registry (AJRR), the Shoulder & Elbow Registry (SER), the Musculoskeletal Tumor Registry (MsTR), and the American Spine Registry (ASR), a collaborative effort between the American Association of Neurological Surgeons and the AAOS.

The FTR’s modules will include:

• Hip fracture—A break in the upper quarter of the femur (thigh) bone that can occur from a fall or from a direct blow to the side of the hip. Conditions such as osteoporosis, cancer, or stress injuries can weaken the bone and make the hip more susceptible to breaking. This will be a collaborative module with AJRR.
  
  
• Distal radius fracture—A common wrist injury after a fall onto an outstretched hand.
  
  
• Ankle fracture—A common injury most often caused by twisting the ankle.
  
  
• Distal femur fracture—A break of the thigh bone just above the knee.
  
  
• Proximal humerus fracture—A shoulder fracture often seen in older patients with osteoporotic bones following a simple ground-level fall on an outstretched arm (future module planned in collaboration with the SER).

“When we integrated the AJRR back into the Academy in 2017, our vision was to make sure that all modalities of musculoskeletal care were represented in the registries portfolio,” said William J. Maloney, MD, FAAOS, chair of the Registry Oversight Committee. “Not only does the Fracture & Trauma Registry get us that much closer to our goal, but it is the first registry to offer crossover benefits for our participants with the creation of collaborative modules.”

“Regardless of a patient’s age or degree of fracture, we as orthopaedic surgeons must take up the charge and follow our patients’ outcomes, gather the data, and determine the optimal treatments for them,” added Douglas W. Lundy, MD, FAAOS, AAOS FTR Steering Committee member. “The Fracture & Trauma Registry is not just another database; it is a powerful tool that helps fill a gap among the current orthopaedic registry programs by tracking evidence-based best practices that will help the musculoskeletal healthcare community provide the highest quality care.”

[1] https://www.boneandjointburden.org/fourth-edition/iva2/fragility-fractures

[2] Burge R, Dawson-Hughes B, Solomon DH, et al.: Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res. 2007;22:465–475.

All orthopaedic surgeons who may encounter fractures in their practice are encouraged to participate in the FTR. To get involved with the FTR, email an AAOS Registry Engagement Associate at RegistryEngagement@aaos.org or visit www.aaos.org/registries. 

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