Knowledge of orthopaedic surgeons in managing patients with fragility fracture

Abstract

Purpose Fragility fractures represent a major health problem, as they cause deformity, disability and increased mortality rates. Orthopaedic surgeons should identify patients with fragility fractures and manage their osteoporosis in order to reduce the risk of future fracture; therefore, orthopaedic surgeons' knowledge about managing fragile fracture should be evaluated. Methods A questionnaire was administered to 2,910 orthopaedic surgeons to address the respondents' knowledge. The questions covered the topics of diagnosis, treatment and approach to a patient with a fragility fracture. The datacollection period for this survey spanned one year. Results There were 2,021 orthopaedic surgeons who participated in this study. Less than 10% of the respondents included bone mass densitometry (BMD) when evaluating patients with fragile fractures 32% prescribed proper dosage of calcium and vitamin D; approximately 30% would refer if falling from a height was suspected. Conclusions The majority of orthopaedic surgeons questioned lacked knowledge of fragility fracture management. This is reflected by limited knowledge of osteoporosis assessment and treatment in most areas. An appropriate method should be created to manage patients with fragility fractures to guarantee the patient the best possible care.

Prevalence of Vitamin D Deficiency in Patients Presenting with an Orthopaedic Trauma at a Tertiary Centre in South India - Implications and Protocols for Replacement Therapy

“…Vitamin D deficiency in the adult patient need not always be associated with frank radiological signs of osteomalacia. Other signs and symptoms like vague bone pains and proximal muscle weakness are not always evaluated or treated and hence patients may be labelled as clinically normal 23 , 24 . Even if patients in this group were clinically asymptomatic, they may all benefit from supplementation post injury considering the benefit of Vitamin D on bone health, calcium metabolism and improved rehabilitative potential 24 , 25 .…”

Bone Health Improvement Protocol

“…The incidence and lifetime risk of any fracture doubles every decade after 50 year-old. 4 , 11 , 13 – 15 During the visit, a standard medical history also should be obtained, with particular attention paid to age, weight, personal and family history of fracture, physical inactivity, medication, alcohol, tobacco, and frailty.…”

“…Orthopedic residency and curricula may not provide sufficient knowledge or training to allow osteoporosis management. 11 Edwards et al 12 demonstrated a modest increase in certain aspects of bone health order pathways and treatment by using an electronic medical record order set. That intervention created with providers’ input increased the follow-up and treatment of patients with osteoporosis.…”

Are Orthopedic Surgeons Subjective Intraoperative Conclusions About Bone Mass Accurate?

“…These research questions seem very important, because many orthopedic surgeons hesitate to screen patients with fragility fracture for osteoporosis, as they claim to be without knowledge about treating osteoporosis. In a survey of 2021 orthopedic surgeons, less than 10% answered that they would use BMD when evaluating patients with fragility fractures and only 17% claimed to have knowledge about managing osteoporosis according to the results of BMD analysis [2].…”