[Recent progress in orthopaedic managements of osteoporosis-related fractures]

Recent progress in orthopaedic treatment of osteoporosis-related fractures was reviewed. In the femoral neck fractures, the bipolar prosthesis reduces acetabular erosion or central migration, and press-fit stem or cemented stem lowers the incedence of the stem sinking. In thorocanteric fractures, compression hip screws are most commonly used, however, in the cases of unstable fractures with severe osteoporosis, it is difficult to start weight-bearing within a few weeks of surgery because varus deformites or translations at the fracture site sometimes occur. To avoid this disadvantage, the gamma nail has been found to be more effective. In paralysis due to burst fractures of the osteoporotic spine, surgical decompression and spinal instrumentation is the established response. A special orthosis named 'rucksack type orthosis' has been devised and is used for patients who have back pain due to anterior bending posture of the trunk. In distal radius fractures, external fixators are now more frequently used.