title: Managing osteoporosis in patients with fragility fractures: did the British Orthopaedic Association guidelines have any impact?
abstract: BACKGROUND
  The incidence of fragility fractures could double in the next 50 years. Effective treatments for osteoporosis exist and the British Orthopaedic Association (BOA) has guidelines governing how to manage underlying osteoporosis in patients with fragility fractures. This study assessed how well two trauma units treat underlying osteoporosis and whether the BOA guidelines made any impact.
  
  
  METHODS
  Case notes of patients with a fracture of their proximal femur admitted during January and February in 2003, 2004 and 2005 were reviewed. The results were analysed for differences between site and year.
  
  
  RESULTS
  A total of 602 case notes were reviewed. There was a significant difference in the number of patients discharged on osteoporosis medication between the two sites (27% at LRI, 8% at KGH; P < 0.001), but not between 2003 and 2005 (22% and 16%; P = 0.16). Of the patients started on treatment, 83% were started on calcium and/or vitamin D(3) supplements.
  
  
  CONCLUSIONS
  The number of patients who had their underlying osteoporosis addressed was low and the type of treatment sub-optimal. This suggests the BOA guidelines have not made an impact and further work is required to improve the management of these patients.
authors: Department of Orthopaedic Surgery, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Leicester, UK. mfnixon@gmail.com
authors: M F
authors: MF
authors: Nixon
authors: T
authors: T
authors: Ibrahim
authors: Y
authors: Y
authors: Johari
authors: S
authors: S
authors: Eltayef
authors: D
authors: D
authors: Hariharan
authors: G J
authors: GJ
authors: Taylor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D005264:Femoral Fractures / Q000601:surgery*; D005598:Fractures, Spontaneous / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D011182:Postoperative Care / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000706:statistics & numerical data; D011364:Professional Practice; D012307:Risk Factors; D014850:Waiting Lists
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates
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