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J Am Acad Orthop Surg, Vol 12, No 6, November/December 2004, 385-395.
© 2004 the American Academy of Orthopaedic Surgeons

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Recommendations for Optimal Care of the Fragility Fracture Patient to Reduce the Risk of Future Fracture

Mary L. Bouxsein, PhD, John Kaufman, MD, Laura Tosi, MD, Steven Cummings, MD, Joseph Lane, MD and Olof Johnell, MD

Dr. Bouxsein is Assistant Professor of Orthopedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA. Dr. Kaufman is a member of the Santa Clarita Orthopedic and Sports Medicine Group, Santa Clarita, CA. Dr. Tosi is Director, Bone Health Program, Division of Orthopaedic Surgery, Children’s National Medical Center, Washington, DC. Dr. Cummings is Professor of Epidemiology and Biostatistics (emeritus), University of California, San Francisco, and Director, San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA. Dr. Lane is Chief, Metabolic Bone Disease Service, Hospital for Special Surgery, New York, NY. Dr. Johnell is Professor, Department of Orthopaedic Surgery, UMAS, Malmö, Sweden.

Reprint requests: Dr. Bouxsein, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215.

Fragility fractures resulting from low trauma events such as a fall from standing height affect up to one half of women and one third of men after age 50 years. These fractures are frequently associated with osteoporosis. History of a fragility fracture is among the strongest risk factors for future fracture. Therefore, optimal care of the patient with a fragility fracture includes not only treatment of the presenting fracture itself but also evaluation and treatment of the underlying cause or causes to prevent future fractures. However, despite the availability of therapeutic agents that reduce fracture risk among osteoporotic patients who have had a fracture, most patients with fragility fractures are not evaluated for osteoporosis or treated adequately to reduce the risk of future fracture. Orthopaedic surgeons are the first and often the only physicians seen by fracture patients. Thus, they have the unique opportunity to serve as primary advocates to ensure that appropriate action is taken to reduce the risk of future fracture.




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L. Gehrig, J. Lane, and M. I. O'Connor
Osteoporosis: Management and Treatment Strategies for Orthopaedic Surgeons
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T. D. Rozental, E. C. Makhni, C. S. Day, and M. L. Bouxsein
Improving Evaluation and Treatment for Osteoporosis Following Distal Radial Fractures. A Prospective Randomized Intervention
J. Bone Joint Surg. Am., May 1, 2008; 90(5): 953 - 961.
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