Secondary prevention of fragility fractures by orthopaedic teams in the UK: a national survey.
OBJECTIVE
To assess secondary prevention of fragility fractures by orthopaedic surgeons in the UK and study the effect of multidisciplinary approach in providing secondary prevention.


METHODS
A survey was conducted consisting of a postal questionnaire sent to 1000 UK orthopaedic surgeons. 750 valid responses were received.


RESULTS
The survey revealed poor compliance with existing guidelines. In the 60- to 80-year age group, the presence of a fracture liaison nurse made a significant difference in the prescription of vitamin D and calcium, providing weight bearing advice, fall risk assessment and dual energy x-ray absorptiometry (DEXA) scan requests. Orthogeriatric service made a significant difference in providing weight bearing advice and DEXA scan requests. In the above 80-year age group, fracture liaison nurses made a significant difference in provision of fall risk assessment and weight bearing advice. Orthogeriatric services made a significant difference in prescribing vitamin D and calcium, providing weight bearing advice and for DEXA scan requests.


CONCLUSIONS
The study re-emphasises the inadequate initiation of secondary preventive measures by orthopaedic units. It also highlights the importance of orthogeriatric and fracture liaison nurse services in improving compliance with existing guidelines.
Chakravarthy
J
J
South Birmingham Trauma Unit, Selly Oak Hospital, Birmingham, UK. cs_jagan@yahoo.com
Ali
A
A
Iyengar
S
S
Porter
K
K
D015502:Absorptiometry, Photon; D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000627:therapeutic use; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D019983:Guideline Adherence / Q000592:standards*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000592:standards*; D010024:Osteoporosis / Q000150:complications / Q000451:nursing / Q000628:therapy*; D011364:Professional Practice / Q000592:standards*; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000627:therapeutic use; D016474:Weight-Bearing
D014807:Vitamin D; D002118:Calcium