The role of the orthopaedic surgeon in minimizing mortality and morbidity associated with fragility fractures.

Osteoporosis is an underrecognized and undertreated condition associated with fracture. More than 2 million fragility fractures occur each year, almost 300,000 of them hip fractures associated with a threefold risk for future fractures, as well as a 15% to 33% mortality rate within the first year of fracture. Orthopaedic surgeons can facilitate osteoporosis treatment by coordinating care for patients with fragility fractures by managing the current fracture, evaluating risk factors for osteoporosis, and, for hospitalized patients, developing a follow-up plan that notes whether the patient should be further evaluated or treated for osteoporosis. For the patient seen in the office, evaluation for osteoporosis should be performed and, if indicated, treatment should be undertaken. When osteoporosis treatment is warranted, diphosphonates are the standard of care, and administration of zoledronic acid once yearly has been proven to reduce the risk of subsequent fractures after low-energy hip fracture. By following these steps, orthopaedic surgeons can help ensure that patients with fragility fractures receive appropriate osteoporotic treatment, thereby reducing the risk of subsequent fractures.