Are osteoporotic fractures being adequately investigated? A questionnaire of GP & orthopaedic surgeons.
BACKGROUND
To investigate the current practice of Orthopaedic Surgeons & General Practitioners (GP) when presented with patients who have a fracture, with possible underlying Osteoporosis.


METHODS
Questionnaires were sent to 140 GPs and 140 Orthopaedic Surgeons. The participants were asked their routine clinical practice with regard to investigation of underlying osteoporosis in 3 clinical scenarios. 55 year old lady with a low trauma Colles fracture. 60 year old lady with a vertebral wedge fracture. 70 year old lady with a low trauma neck of femur fracture.


RESULTS
Most doctors agreed that patients over 50 years old with low trauma fractures required investigation for osteoporosis, however, most surgeons (56%, n = 66) would discharge patients with low trauma Colles fracture without requesting or initiating investigation for osteoporosis. Most GPs (67%, n = 76) would not investigate a similar patient for osteoporosis, unless prompted by the Orthopaedic Surgeon or patient. More surgeons (71%, n= 83) and GPs (64%, n = 72) would initiate investigations for osteoporosis in a vertebral wedge fracture, but few surgeons (35%, n = 23) would investigate a neck of femur fracture patient after orthopaedic treatment.


CONCLUSIONS
Most doctors know that fragility fractures in patients over 50 years old require investigation for Osteoporosis; however, a large population of patients with osteoporotic fractures are not being given the advantages of secondary prevention.
Chami
George
G
Department of Computer Science, Hull University, Hull, UK. georgechami@doctors.org.uk
Jeys
Lee
L
Freudmann
Mathew
M
Connor
Louise
L
Siddiqi
Mashood
M
D000368:Aged; D003100:Colles' Fracture / Q000209:etiology* / Q000601:surgery; D003266:Continuity of Patient Care; D004739:England; D005194:Family Practice / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005264:Femoral Fractures / Q000209:etiology* / Q000601:surgery; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000379:methods* / Q000706:statistics & numerical data; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D017064:Process Assessment, Health Care; D016103:Spinal Fractures / Q000209:etiology* / Q000601:surgery; D011795:Surveys and Questionnaires