title: Future perspectives: the need for large clinical trials.
abstract: Fragility fractures represent a growing problem with large economic and patient burdens that are likely to increase as the population ages. The elderly patient with osteopenic bone presents a unique surgical challenge with appreciable risks associated with each surgical treatment option. As demonstrated in this supplement, the current evidence suggests that the best surgical treatment options for patients with fragility fractures remains largely unknown. Additional evidence, from large clinical trials, is required before definitive treatment recommendations can be made in many cases. In this article, we review the example of the femoral neck fracture to illustrate this point.
authors.affiliation: Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Clary J
authors.initials: CJ
authors.lastname: Foote
authors.forename: Sheila
authors.initials: S
authors.lastname: Sprague
authors.forename: Emil H
authors.initials: EH
authors.lastname: Schemitsch
authors.forename: Mohit
authors.initials: M
authors.lastname: Bhandari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement; D015519:Bone Density; D017760:Bone Malalignment; D002986:Clinical Trials as Topic; D015897:Comorbidity; D005265:Femoral Neck Fractures / Q000209:etiology / Q000601:surgery*; D005598:Fractures, Spontaneous / Q000209:etiology / Q000601:surgery*; D016330:Frail Elderly; D006801:Humans; D019637:Orthopedic Procedures; D010024:Osteoporosis / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation