Hip Fractures in Malta: Are we Missing an Opportunity?
Surg J (N Y). 2021 Jul 22;7(3):e184-e190. doi: 10.1055/s-0041-1731635
Mark Bugeja 1, Arthur Curmi 1, Daniel Desira 1, Gregory Apap Bologna 1, Francesco Galea 1, Ivan Esposito 1
Probably less than 10% of all Vitamin D prescriptions are large enough to be of a benefit
- Why are doctors reluctant to accept vitamin D
- Do not expect your doctor to know about vitamin D
- Do not expect a doctor to recommend a pill which will eliminate his job (vitamin D)
- Curing patients is not a sustainable business model – Goldman Sachs – April 2018
- VITAMIN D: Public Shouldn’t Wait For Doctors To Usher In New “Golden Era” Of Preventive Medicine
- Let 1000 die from vitamin D deficiency rather than incur 1 lawsuit
- Survey Shows Dogma Not Data Can Dictate Doctors' Decisions - June 2010
Suspect that 50% of hip fractures could be avoided by proactively getting enough vitamin D, exercise, etc
Falls and Fractures category contains the following
225 items in FALLS and FRACTURES - see also Overview Seniors and Vitamin D
- Overview Fractures and Falls and Vitamin D
- Deaths due to falls doubled in just a decade (age-adjusted, perhaps decreased vitamin D) – June 2019
- Low trauma bone fractures in seniors – considering Vitamin D loading dose for all, without testing – Nov 2019
- Preventing Falls in Older Adults – Vitamin D combination is the best - JAMA Meta-analysis Nov 2017
- Falls cut in half by 100,000 IU vitamin D monthly - RCT 2016
- Vitamin D prevents falls – majority of meta-analyses conclude – meta-meta analysis Feb 2015
- Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
Hip fracture
- Search VitaminDWiki for "HIP FRACTURE" 191 items not in PDF as of July 2020
- A call to action: Vitamin D for hip fracture (50,000 weekly for 8 weeks, then bi-weekly – Holick July 2020
- Recommends vitamin D after hip fracture ( but not enough and no-bone building co-factors) – May 2021
- Risk factors for death after hip fracture surgery – 7 of the 8 are associated with low vitamin D – Aug 2020
- 3.5 X higher risk of death 2 years after hip fracture surgery if low vitamin D – Jan 2020
- Hip fracture recovery best with home exercise plus Vitamin D – RCT Dec 2018
- Hip fracture 58 percent more likely if low vitamin D – meta-analysis March 2017
- Fracture risk 40 percent higher risk if low Vitamin D - June 2019
- 1 in 3 died after hip fracture but only 1 in 14 if add Vitamin D and exercise – RCT April 2017
Bone - Health category starts with the following
284 items in Bone - Health category
See also- Overviews: Osteoporosis, Fractures, Rickets Dental Hair
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14 articles are in both Bone and Magnesium categories 26 articles are in both Bone and Vitamin K2 categories 16 articles are in both Bone and Sports categories 7 articles are in both Bone and Meta-analysis categories 23 articles are in both Fractures and Meta-analysis categories - Healthy bones need: Calcium, Vitamin D, Magnesium, Silicon, Vitamin K, and Boron – 2012
- Search VitaminDWiki for BMD OR "Bone Mineral Density" 3490 results as of Feb 2021
- Hearing loss is associated with soft bones in ear
- Perhaps prevented and treated by Vitamin D
Download the PDF from VitaminDWiki
Introduction Osteoporosis is a bone disease that is both preventable and treatable. It usually becomes evident when a fragility fracture occurs. Unfortunately, most studies show that only a small percentage of individuals at increased risk of fracture are assessed and treated, even following a fragility fracture.
Objective The aim of this study was to determine whether patients suffering from a low-energy hip fractures in the Maltese Islands are given osteoporosis treatment. Method All patients older than 50 years presenting to the acute care hospitals in Malta and Gozo with a fragility hip fracture during December 1, 2015 and November 30, 2016 were included. Data on mortality, other fragility fractures, prescription of calcium, vitamin D, and antiresorptive therapy were collected.
Results Calcium with vitamin D supplements were prescribed to 40% of patients; however, only 2.64% of patients were given pharmacological therapy. Following a hip fracture, the mortality rate was 18.5% at 1 year and 26.21% at 2 years. Apart from a high mortality rate, 28.19% of individuals sustained another fragility fracture before or after the hip fracture.
Conclusion There should be increased osteoporosis awareness in Malta and a national bone mineral density screening program should be set up. An active role of the orthogeriatrics team in the management and treatment of osteoporosis following a fragility fracture might improve treatment rate and decrease refracture and mortality rates.
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