Bone mineral density testing after fragility fracture: Informative test results likely

Area of Science:

• Osteoporosis research
• Geriatric medicine
• Public health

Background:

• Fragility fractures are a significant health concern, particularly in older adults.
• Bone mineral density (BMD) testing is crucial for diagnosing osteoporosis and guiding treatment.
• Family physicians (FPs) play a key role in managing patients with fractures and assessing osteoporosis risk.

Purpose of the Study:

• To determine the proportion of patients with fragility fractures who have low bone mineral density (BMD).
• To provide evidence to assist FPs in deciding when to refer patients for BMD testing.
• To inform fracture risk assessment and management strategies.

Main Methods:

• Systematic review of English-language articles from MEDLINE, EMBASE, and CINAHL databases.
• Inclusion of studies reporting BMD results in patients with fragility fractures managed in orthopedic settings.
• Analysis of factors influencing BMD test results and calculation of low BMD rates.

Main Results:

• Summarized the distribution of low BMD proportions across studies using descriptive statistics.
• Calculated lower boundaries of expected low BMD rates.
• Identified that at least two-thirds of patients over 50 with fragility fractures have low BMD (T score ≤ -1.0).

Conclusions:

• Family physicians can expect a high prevalence of low BMD in older patients with fragility fractures.
• This expectation can encourage FPs to perform fracture risk assessments and implement risk reduction strategies.
• Early identification and management of osteoporosis following fragility fractures are essential.