Fracture Begets Fracture
Fragility fractures affect about 2.5 million people yearly in the United States and millions more worldwide. Once a fragility fracture occurs, there is 50% likelihood that another fracture will take place. In fact, 50% of hip fracture patients have had a prior fragility fracture. As orthopaedic surgeons, we have the opportunity to significantly impact the number of second fractures and the morbidity associated with these fractures. Every fragility fracture patient, including the 45-year-old with a distal radius fragility fracture, should have an osteoporosis evaluation, and/or discussions about bone health, calcium, Vitamin D, weight bearing exercises, home safety, etc.
In addition, it may be worth considering developing a Fracture Liaison Service (FLS), which can have a significant impact on second fractures. With “usual care,” fewer than 20% of these patients will start pharmacologic treatment for their osteoporosis; this number can be improved to ≥80% with an FLS. National Bone Health Alliance and Own the Bone both have several resources on the FLS model of care and information on how to get an FLS started. As orthopaedic surgeons, we can have a dramatic impact on reducing future fracture occurrences thereby increasing patient quality of life.
Kimberly Furry, MD
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