Are osteoporotic fractures being adequately investigated?: A questionnaire of GP & orthopaedic surgeons

Author:

Chami George,Jeys Lee,Freudmann Mathew,Connor Louise,Siddiqi Mashood

Abstract

Abstract Background To investigate the current practice of Orthopaedic Surgeons & General Practitioners (GP) when presented with patients who have a fracture, with possible underlying Osteoporosis. Methods Questionnaires were sent to 140 GPs and 140 Orthopaedic Surgeons. The participants were asked their routine clinical practice with regard to investigation of underlying osteoporosis in 3 clinical scenarios. 55 year old lady with a low trauma Colles fracture 60 year old lady with a vertebral wedge fracture 70 year old lady with a low trauma neck of femur fracture. Results Most doctors agreed that patients over 50 years old with low trauma fractures required investigation for osteoporosis, however, most surgeons (56%, n = 66) would discharge patients with low trauma Colles fracture without requesting or initiating investigation for osteoporosis. Most GPs (67%, n = 76) would not investigate a similar patient for osteoporosis, unless prompted by the Orthopaedic Surgeon or patient. More surgeons (71%, n= 83) and GPs (64%, n = 72) would initiate investigations for osteoporosis in a vertebral wedge fracture, but few surgeons (35%, n = 23) would investigate a neck of femur fracture patient after orthopaedic treatment. Conclusion Most doctors know that fragility fractures in patients over 50 years old require investigation for Osteoporosis; however, a large population of patients with osteoporotic fractures are not being given the advantages of secondary prevention.

Publisher

Springer Science and Business Media LLC

Subject

Family Practice

Reference17 articles.

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2. Mallmin H, Ljunghall S: Distal radius fracture is an early sign of general osteoporosis: bone mass measurements in a population-based study. Osteoporos Int. 1994, 4 (6): 357-361. 10.1007/BF01622198.

3. Owen RA, Melton LJ, Ilstrup DM, Johnson KA, Riggs BL: Colles' fracture and subsequent hip fracture risk. Clin Orthop Relat Res. 1982, 37-43.

4. Finsen V, Benum P: Colles' fracture as an indicator of increased risk of hip fracture. An epidemiological study. Ann Chir Gynaecol. 1987, 76 (2): 114-118.

5. Melton LJ, Atkinson EJ, Cooper C, O'Fallon WM, Riggs BL: Vertebral fractures predict subsequent fractures. Osteoporos Int. 1999, 10 (3): 214-221. 10.1007/s001980050218.

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