title: Missed opportunities in patients with osteoporosis and distal radius fractures.
abstract: Low-energy wrist (distal radius) fractures are hallmarks of osteoporosis. Prompt diagnosis and treatment of osteoporosis reduce refracture rates. We retrospectively determined the type and frequency of osteoporosis-related interventions rendered to patients 50 years and older in the year after a wrist fragility fracture. In addition, we compared the rates of intervention between men and women. Data were collected from the computerized medical record of one military healthcare system. We identified 111 patients who sustained wrist fragility fractures between July and December 2002. Endocrinology referrals, dual-energy xray absorptiometry scans, and osteoporosis medication prescriptions in the year after their fracture were recorded. Overall, 28 patients (25%) were referred to endocrinology, 22 patients (20%) had a dual-energy xray absorptiometry scan, 33 patients (30%) were prescribed an approved medication for treatment of osteoporosis, and 52 patients (47%) were prescribed one of these medications and/or vitamin D and calcium. Sixty percent of patients received at least one intervention. All diagnostic and medical interventions were more likely ordered for women than men. Orthopaedic surgeons continue to miss opportunities to initiate diagnostic and therapeutic interventions for patients, especially men, presenting with fragility fractures.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, Washington, DC, USA. brettfreedman@yahoo.com
authors.forename: Brett A
authors.initials: BA
authors.lastname: Freedman
authors.forename: Benjamin K
authors.initials: BK
authors.lastname: Potter
authors.forename: Leon J
authors.initials: LJ
authors.lastname: Nesti
authors.forename: Timothy
authors.initials: T
authors.lastname: Cho
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Kuklo
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D010024:Osteoporosis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D011287:Prejudice; D011885:Radius Fractures / Q000209:etiology* / Q000517:prevention & control; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D; D002118:Calcium