[Assessment and treatment of osteoporotic hip fractures]

Osteoporosis is a major cause of low-energy hip fractures. Although there are pharmacologic agents available for both prevention and treatment, less than 10% of hip fracture cases initiate anti-osteoporotic treatment.

In 1995 and 2008, questionnaires were sent to all Danish orthopaedic surgery departments treating patients with low-energy hip fractures, asking them to explain a) whether patients with osteoporosis are identified, b) whether the patients identified are treated for osteoporosis, and c) whether physicians need more information about osteoporosis.

56 departments (97%) returned the questionnaires in 1995 and 25 (95%) in 2008. 40% of the departments did (12% in 1995) refer any patients with low-energy fractures to bone densitometry. 84% treated (11% in 1995) patients with hip fractures with calcium and D vitamin. In 2008, 28% (0% in 1995) of the departments used bisfosfonates after hip fractures (none used yearly zoledronate). More than 80% (54% in 1995) of the departments informed the patients about in the advantages of lifestyle changes. Half of the departments' doctors wanted more information about osteoporosis in 1995 compared with only 16% in 2008. In 2008, 48% of the departments informed the GPs that their patient with a low-energy fracture may have osteoporosis and that further evaluation and treatment may be needed.

Medical treatment after fractures was more widespread in 2008 than in 1995. About half of the Danish departments with orthopaedic surgery functions refer patients to further investigation. There is, however, still room for improvement.