Treating patients with non–neck-of-femur (NOF) fragility fractures from osteoporosis before NOF fractures may improve quality-of-life and reduce burden to hospital services and funding, according to a study published the December 2013 Journal of Orthopaedic Surgery and Research.
“Despite the known impact of fragility fractures, osteoporosis still remains unrecognized and untreated in over 50% of patients who present with fragility fractures,” according to authors Tamer Mettyas, Orthopaedic Department of, Royal Brisbane and Women’s Hospital, Australia, and Clare Carpenter, Orthopaedic Department, University Hospital of Wales, Heath Park, Cardiff, United Kingdoms. “Orthopaedic surgeons are often the first to encounter these patients who present with fragility fractures.”
The investigator sought to evaluate current practice of the National Institute for Health and Clinical Excellence (NICE) and British Orthopaedic Association (BOA) guidelines of the secondary prevention of osteoporosis. Patients 50 years and older who were admitted as in-patients with non-NOF fragility fractures between March and September 2008 were included in the study. Mettyas and Carpenter retrospectively evaluated data from March 2008, including risk factors and whether patients were treated; September data was prospectively evaluated after the new trauma admission sheet was introduced. Finally, the authors performed a cross-sectional study assessing services for NOF and non-NOF fragility fractures in September.
Overall, they found that 29% of fragility fractures were non-NOF (mean age, 70 years), and 71% were NOF fractures (mean age, 80). “There is a great difference in the care provided to these patients,” the authors observed. In particular, non-NOF fragility fractures received less attention for osteoporosis assessment (25%) and less interest for investigation by the medical staff (11%), as well as less attention for the treatment of osteoporosis (35%), compared with NOF fracture (35%, 47%, and 71%, respectively). Furthermore, 25% of NOF patients had previous fragility fractures, compared with 6% of non-NOF patients.
“We believe that treating patients with non-NOF fractures from osteoporosis before proceeding to NOF fractures would improve their quality and reduce the burden on hospital services and funding,” the authors concluded.
Mettyas T, Carpenter C. Secondary prevention of osteoporosis in non-neck of femur fractures: is it value for money? A retrospective, prospective and cross-sectional cohort study. J Orthop Surg Res. 2013;8(1):44.