Abstract
Introduction and aims: Minimal trauma fractures may be the first indication of osteoporosis [OP]. Available data suggests that the continuum of care [EDorthopaedic service-GP] is breaking down with respect to identification and treatment of osteoporosis. Our aim was to determine the extent of this breakdown in the Australasian context.
Methods: Observational retrospective cohort study of patients aged 50 years or over who were treated and discharged with wrist fracture due to minimal trauma. Data collected included demographics, fracture details, cause of injury, bone density testing and osteoporosis-related medication change. Outcomes of interest were the proportion of patients who underwent bone density testing and treatment in the follow-up period.
Results: 131 patients were studied; 83% were female with median age of 71 years. No patient was referred by ED or fracture clinic for bone density testing [0%, 95% CI 0–3.5%]. Telephone follow-up was obtained from 91 patients, of whom 28 [31%] reported having bone density testing after their fracture. 50% [14, 95% CI 32–67%] of these were found to have osteoporosis. Seven patients [8%] commenced treatment with a bisphosphonate and one [1%] commenced a selective oestrogen receptor modulator.
Conclusion: Follow-up of ‘at risk’ patients suffering minimal trauma wrist fractures treated in the ED is poor. Systems to improve identification and treatment of osteoporosis in this group are needed if future osteoporotic fractures and their consequences are to be avoided. Possible models will be put forward.
The abstracts were prepared by David AF Morgan. Correspondence should be addressed to him at davidafmorgan@aoa.org.au
