Are hospitalized patients with fragile fractures managed properly in relation to underlying osteoporosis?

Osteoporotic fractures are an important reason of morbidity and mortality in the elderly population and impose huge economic burden on health services. There have been major advances in the treatment of osteoporosis, and many steps can be taken to prevent or even reduce the risk of fractures. Orthopedic surgeons manage most of these fractures and are often the only clinician seen by the patient.

We performed a survey of 515 patients with osteoporotic fractures who were admitted to 3 level I trauma hospitals in Tehran, Iran. Patients were evaluated with a questionnaire to determine whether orthopedic surgeons informed their patients about aspects of osteoporosis other than their fracture, and if appropriate, evaluation and treatment for osteoporosis were initiated. The questionnaires were completed in 2 years (mean) from their admissions.

Only 10.5% patients reported that they had been told by an orthopedic surgeon that they had osteoporosis. Only 3.3% had bone mineral density appointments. Few had received treatment for osteoporosis-only 8.2% of patients had been treated with calcium and vitamin D, and 3.5% with a bisphosphonate.

We believe that the majority of the orthopedic surgeons lacked sufficient training in osteoporosis; therefore, engaging other providers in their healthcare system can create a pathway for the assessment and treatment of osteoporosis, to guarantee the patient the best care.