Pins and Plaster Aren’t Enough: A Call for the Evaluation and Treatment of Patients with Osteoporotic Fractures

• Published in: The journal of clinical endocrinology and metabolism 2003-08, Vol.88 (8), p.3482-3486
• Main Authors: Siris, Ethel S., Bilezikian, John P., Rubin, Mishaela R., Black, Dennis M., Bockman, Richard S., Bone, Henry G., Hochberg, Marc C., McClung, Michael R., Schnitzer, Thomas J.
• Format: Article
• Language: English
• Subjects: Aged; Bone Density; Clinical Trials as Topic; Fractures, Bone - surgery; Fractures, Bone - therapy; Guidelines as Topic; Humans; Osteoporosis - complications; Osteoporosis - surgery; Osteoporosis - therapy; Predictive Value of Tests
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2003-030568

A history of an osteoporotic fracture is a powerful predictor of future fractures. Older patients who sustain low trauma fractures are candidates for interventions that should include confirmation of the diagnosis of osteoporosis, adequate calcium and vitamin D administration, and use of an osteoporosis therapy that is proven to lower fracture risk. Recently, however, several reports in the literature have indicated that, in general, those physicians who diagnose and treat fractures, i.e. radiologists, orthopedic surgeons, physiatrists, and those who provide general medical care to these fracture patients, the primary care physicians, are not evaluating patients with acute fractures for the presence of osteoporosis and are not prescribing calcium, vitamin D, or specific pharmacological therapy to reduce future fracture risk. These reports suggest that implementation of a standard of care for the subsequent medical management of the older patient with an acute fracture is needed urgently. Diagnostic tools and several effective therapies exist, but these are underused by the physicians who interface with these patients. A call to action is necessary to reduce the human and economic costs associated with this serious and treatable disease.