Low-Trauma Fractures Lack Needed Follow-Up


QUEBEC CITY — Women who have had a low-trauma fracture are not getting the follow-up they need for osteoporosis, Sonia Singh, M.D., reported in a poster at the annual meeting of the North American Primary Care Research Group.

History of a low-trauma fracture is associated with a 40% increased risk of hip fracture, Dr. Singh said.

A retrospective chart review identified 100 women, 40 years or older, who presented with a low-trauma fracture to a community hospital emergency department. A questionnaire was sent to them 6–9 months after a fracture to determine whether they had been given a diagnosis of osteoporosis or received any treatment.

Preliminary results from 42 women showed that 22 (52%) had received no follow-up, 12 (29%) had received an ultrasound or bone mineral density scan, and 8 (19%) had follow-up without testing.

Of the 20 patients with follow-up, 7 (35%) had been prescribed medications.

Interviews with the women revealed only seven (17%) thought they were at an increased risk for another fracture.

Surprisingly, a history of two or three fractures did little to change that perception or to improve medication rates, said Dr. Singh, clinical research associate, Peace Arch Hospital, White Rock, B.C., Canada.

A previous study found similar follow-up and treatment rates, with fewer than 20% of 108 men and women who presented with fragility-type fractures at three Ontario hospitals receiving follow-up 1 year later (CMAJ 2000;163:819–22). “Despite the fact there has been a heightened profile for osteoporosis, that … has not improved the management,” she said.

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