This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Siris, E. S. Articles by Schnitzer, T. J. Search for Related Content PubMed PubMed Citation Articles by Siris, E. S. Articles by Schnitzer, T. J.

Pins and Plaster Aren’t Enough: A Call for the Evaluation and Treatment of Patients with Osteoporotic Fractures

Department of Medicine (E.S.S., J.P.B., M.R.R.), College of Physicians and Surgeons of Columbia University, New York, New York 10032; Department of Epidemiology and Biostatistics (D.M.B.), University of California–San Francisco, San Francisco, California 94105; Department of Medicine (R.S.B.), Weill-Cornell Medical College, New York, New York 10021; Michigan Bone and Mineral Clinic (H.G.B.), Detroit, Michigan 48236; Department of Medicine (M.C.H.), University of Maryland School of Medicine, Baltimore, Maryland 21201; Oregon Osteoporosis Center (M.R.M.), Portland, Oregon 97218; and Department of Medicine (T.J.S.), Northwestern University Medical School, Chicago, Illinois 60611

Address all correspondence and requests for reprints to: Ethel Siris, M.D., Department of Medicine, Columbia University College of Physicians and Surgeons, 180 Fort Washington Avenue, HP 9-964, New York, New York 10032. E-mail: es27{at}columbia.edu.

A history of an osteoporotic fracture is a powerful predictor of future fractures. Older patients who sustain low trauma fractures are candidates for interventions that should include confirmation of the diagnosis of osteoporosis, adequate calcium and vitamin D administration, and use of an osteoporosis therapy that is proven to lower fracture risk. Recently, however, several reports in the literature have indicated that, in general, those physicians who diagnose and treat fractures, i.e. radiologists, orthopedic surgeons, physiatrists, and those who provide general medical care to these fracture patients, the primary care physicians, are not evaluating patients with acute fractures for the presence of osteoporosis and are not prescribing calcium, vitamin D, or specific pharmacological therapy to reduce future fracture risk. These reports suggest that implementation of a standard of care for the subsequent medical management of the older patient with an acute fracture is needed urgently. Diagnostic tools and several effective therapies exist, but these are underused by the physicians who interface with these patients. A call to action is necessary to reduce the human and economic costs associated with this serious and treatable disease.

Abbreviations: BMD, Bone mineral density; NOF, National Osteoporosis Foundation.

This article has been cited by other articles:

				S. R. Majumdar MD MPH, J. A. Johnson PhD, F. A. McAlister MD MSc, D. Bellerose BScN, A. S. Russell MD, D. A. Hanley MD, D. W. Morrish MD PhD, W. P. Maksymowych MD, and B. H. Rowe MD MSc Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture: a randomized controlled trial Can. Med. Assoc. J., February 26, 2008; 178(5): 569 - 575. [Abstract] [Full Text] [PDF]

				L. L. Tosi, R. Gliklich, K. Kannan, and K. J. Koval The American Orthopaedic Association's "Own the Bone" Initiative to Prevent Secondary Fractures J. Bone Joint Surg. Am., January 1, 2008; 90(1): 163 - 173. [Abstract] [Full Text] [PDF]

				S. R. Majumdar, L. A. Beaupre, C. H. Harley, D. A. Hanley, D. A. Lier, A. G. Juby, W. P. Maksymowych, J. G. Cinats, N. R. Bell, and D. W. Morrish Use of a Case Manager to Improve Osteoporosis Treatment After Hip Fracture: Results of a Randomized Controlled Trial Arch Intern Med, October 22, 2007; 167(19): 2110 - 2115. [Abstract] [Full Text] [PDF]

				C. I. Rohr, J. M. Clements, and A. Sarkar Treatment and prevention practices in postmenopausal women after bone mineral density screening at a community-based osteoporosis project. J Am Osteopath Assoc, July 1, 2006; 106(7): 396 - 401. [Abstract] [Full Text] [PDF]

				H. Liu, K. Michaud, S. Nayak, D. B. Karpf, D. K. Owens, and A. M. Garber The Cost-effectiveness of Therapy With Teriparatide and Alendronate in Women With Severe Osteoporosis. Arch Intern Med, June 12, 2006; 166(11): 1209 - 1217. [Abstract] [Full Text] [PDF]

				D. T Gold, I. M Alexander, and M. P Ettinger How Can Osteoporosis Patients Benefit More from Their Therapy? Adherence Issues with Bisphosphonate Therapy Ann. Pharmacother., June 1, 2006; 40(6): 1143 - 1150. [Abstract] [Full Text] [PDF]

				M. L. Bouxsein, J. Kaufman, L. Tosi, S. Cummings, J. Lane, and O. Johnell Recommendations for Optimal Care of the Fragility Fracture Patient to Reduce the Risk of Future Fracture J. Am. Acad. Ortho. Surg., November 1, 2004; 12(6): 385 - 395. [Abstract] [Full Text] [PDF]

				S. R. Majumdar, B. H. Rowe, D. Folk, J. A. Johnson, B. H. Holroyd, D. W. Morrish, W. P. Maksymowych, I. P. Steiner, C. H. Harley, B. J. Wirzba, et al. A Controlled Trial To Increase Detection and Treatment of Osteoporosis in Older Patients with a Wrist Fracture Ann Intern Med, September 7, 2004; 141(5): 366 - 373. [Abstract] [Full Text] [PDF]