[From fragility fracture to secondary prevention - no standardized care pathways]

To better understand the shortcomings and underlying causes in secondary fracture prevention, it is important to consult the different healthcare professionals involved in fracture care. As a first step, orthopedic surgeons at Swedish orthopedic clinics were approached. The aim was to gain insight into how these clinics perceive and manage patients with fragility fractures and suspected underlying osteoporosis. We found considerable variation in how orthopedic departments in Sweden initiate secondary prevention following fragility fractures. Referral to primary care is the most common approach, though other measures are also used. Despite national recommendations, no consensus exists on standardized procedures, and collaboration within the fracture liaison service is often perceived as insufficient. Many clinics lack a fracture coordinator, a role intended to ensure coordinated care for these patients. The findings highlight the need to follow established guidelines and strengthen cooperation across different levels of care to achieve more equitable treatment for patients with fragility fractures and suspected underlying osteoporosis.