The orthogeriatric cycle and orthogeriatric taxonomy: definitions, classifications, and conceptual elements for a better clinical practice

Abstract

The incidence of fragility fractures is increasing. This group of diseases, mainly hip fractures, has enormous clinical, social, organizational, epidemiological, and economic impact. Orthogeriatrics emerged in the 1960s as a response to the impact of hip fractures on health systems. Since then, the cost-effectiveness of co-management models has been demonstrated, and the field of orthogeriatrics has expanded from acute care to prevention, rehabilitation, and follow-up, including involvement from clinical, academic, administrative, and political sectors. This has made associated indicators and standards increasingly complex. Moreover, orthogeriatrics initiatives are quite diverse throughout the world, since they arise due to varied local circumstances. Thus, it is necessary to review the foundations of the specialty to facilitate decision-making, comparison between models, and continuous improvement. In this article, we review current definitions and concepts in orthogeriatrics based on classic publications. We also reviewed the classifications of care models and carried out an evolutionary analysis of the field. Finally, we propose a taxonomic system that considers clinical, evolutionary, and functional aspects.