What is the role of the orthopaedic surgeon in management of fragility fractures?

J Orthop Trauma. 2011 Jun;25 Suppl 1:S47-50.

Sharif KM, Dimitriou R, Giannoudis PV.

Trauma & Orthopaedics, Manor Hospital, Walsall, UK.

Fragility fractures are the most prevalent trauma condition that orthopaedic surgeons face today. Osteoporosis and susceptibility to falls are the key predisposing factors. Despite evidence supporting the impact of treating osteoporosis on reducing the incidence of fragility fractures, it is often left untreated. Orthopaedic surgeons are often the first physicians to assess and treat the patient after a fragility fracture. Their role therefore does not end in the skillful fixation of the fractures, but they have a unique opportunity to ensure that preventive measures are implemented. This includes falls prevention, investigation of possible causes underlying osteoporosis, attention to diet, exercise, calcium, and vitamin D supplementation as well as prescription of anti-resorptive and anabolic medication. The need for a dedicated multidisciplinary team needs to be emphasized and therefore effective communication between the different parties is of paramount importance.

PMID: 21566474

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Hardly talked about vitamin D at all

From the article

“Most of the surgeons in Germany, Italy, and Spain felt competent in prescribing calcium/vitamin D and bisphosphonates compared with less than 50% of their colleagues in France, the United Kingdom, and New Zealand.”

Reference for the quote: Dawson-Hughes B, Tosteson AN, Melton LJ, et al. Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA. Osteoporosis Int. 2008;19:449–458.

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