Surgical approach to fragility fractures: problems and perspectives

The frequency of osteoporosis is constantly increasing all over the world. This pathology generates several problems, mostly due to fragility fractures, the worst consequence of impaired bone quality. Osteoporotic fractures often cause disability and loss of independence, partly because fracture fixation is not always easy and durable. So orthopedic surgeons need to learn and use new techniques to improve bone healing and surgical outcome, in order to grant fragility fracture patients a good quality of life. There are nails, screws and plates designed to maximize the bone-implant interface, substances which can be used locally to stimulate bone formation, and systemic therapies which can be used as adjuvants to decrease bone loss and/or enhance bone formation. Here, we report our personal experience, describing our surgical patients and their response to a bone-forming agent, such as teriparatide.