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Case studies

The GP's role in postfragility fracture management

Monica Taylor, Dan Ewald

Figures

© GRINVALDS/ISTOCKPHOTO.COM
© GRINVALDS/ISTOCKPHOTO.COM

Abstract

Osteoporosis is characterised by low bone mineral density and architectural deterioration which leads to reduced bone strength and increased fracture risk. This progressive process has no symptoms and is therefore frequently underdiagnosed, often first presenting with a minimal trauma fracture.

Key Points

  • Despite the availability of safe and effective treatments there is a large evidence-practice gap in osteoporosis care, including following minimal trauma fracture.
  • All men from 50 years of age and all postmenopausal women (without a minimal trauma fracture) should be screened for risk factors for osteoporosis; some will warrant bone mineral density testing.
  • All patients who experience a fracture from minimal trauma should be assessed for osteoporosis.
  • Patients taking oestrogen or androgen deprivation therapy or those taking steroids for more than three months are at high risk of osteoporosis.
  • Always consider secondary causes of osteoporosis in patients affected by low bone mineral density and systematically exclude potential contributors.
  • Ongoing monitoring should focus on diet, safe sun exposure, exercise and harmful medications; falls risk reduction and osteoporosis medication adherence should be reviewed.

Figures

© GRINVALDS/ISTOCKPHOTO.COM
© GRINVALDS/ISTOCKPHOTO.COM