title: Prevalence of bone mineral density testing and osteoporosis management following low- and high-energy fractures.
abstract: OBJECTIVE
  The aim of this study was to report the prevalence of post-fracture bone mineral density (BMD) testing and osteoporosis treatment in patients admitted to the orthopedic department for low-energy or high-energy fractures and to identify factors affecting prevalence of post-fracture BMD testing and osteoporosis treatment.
  
  
  METHODS
  A total of 265 patients aged 45 years or older admitted with low-energy or high-energy fractures were reviewed between January 2010 and May 2011. Information regarding age, gender, fracture site and history of post-fracture BMD testing and osteoporosis treatment, including data reporting experiences of attending orthopedists (young: <10, senior: >10 years of experience) were recorded.
  
  
  RESULTS
  Of the 265 patients (175 female, 90 male), 259 (97.7%) patients had low-energy fractures and 6 (2.3%) suffered high-energy fractures. Of 259 low-energy fractures, 99 (38.2%) underwent BMD testing and had mean total T-scores of -2.04±1.01 (proximal-femur) and -2.12±1.27 (lumbar-spine). Only one high-energy fracture patient (16.7%) underwent BMD testing, with a T-score of -1.1 (proximal-femur) and -2.7 (lumbar-spine). Eighty-six (32.5%) patients (85 low-energy fractures; 1 high-energy fracture) with diagnosis of osteopenia/osteoporosis from BMD testing were treated with calcium, vitamin D, and bisphosphonates. Bone mineral density testing was significantly higher in low-energy fracture patients who were treated by a young orthopedist, a common fracture site (proximal-femur, distal-radius, vertebrae) or were female (p<0.05).
  
  
  CONCLUSIONS
  Bone mineral density investigation and treatment rates are currently suboptimal. The current gap in adequate care necessitates multidisciplinary intervention in order to lessen the incidence of future fractures, particularly in patients over the age of 45.
authors.affiliation: Department of Orthopedic Surgery, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.
authors.forename: Chayanin
authors.initials: C
authors.lastname: Angthong
authors.forename: Santi
authors.initials: S
authors.lastname: Rodjanawijitkul
authors.forename: Supawat
authors.initials: S
authors.lastname: Samart
authors.forename: Wirana
authors.initials: W
authors.lastname: Angthong
mesh_terms: D015502:Absorptiometry, Photon / Q000706:statistics & numerical data*; D000368:Aged; D015519:Bone Density / Q000502:physiology*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D017610:Calcium Compounds / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000175:diagnosis; D005269:Femur / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications / Q000175:diagnosis; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D017610:Calcium Compounds; D004164:Diphosphonates; D014807:Vitamin D