Abstract
Introduction
The purpose of this study was to establish whether men and women with a fragility hip fracture were equally investigated and treated for osteoporosis.
Methods
A retrospective review was carried out including 91 patients (48 females, 43 males) who were admitted with a fragility hip fracture between March 2003 and April 2004. Data about age, sex, investigations and medication were collected from the case notes, GP surgeries and the bone densitometry database. Investigations and treatment were compared with current guideline recommendations (SIGN 2003, NICE 2005). Data were analysed using SPSS Version 13.0.
Results
According to the guidelines patients < 75 years of age should be investigated and patients > 75 years should be treated for osteoporosis. In our review 33% of women and only 8% of men < 75 years were investigated with a DEXA scan following their hip fracture (Fishers Exact Test, p = 0.32). In patients > 75 years 25% of women and only 6% of men were treated with bisphosphonates (Chi-square = 4.18, p < 0.05). There was also a statistically significant difference in overall treatment including bisphosphonates and calcium/vitamin D between the sexes (Chi-square = 6.81, p < 0.05).
Conclusion
This study shows that there is clearly a need for improvement in secondary prevention of fragility fractures in both sexes, but men are significantly less likely to be investigated and treated than women. It is important to include recommendations for men in future guidelines and increase the awareness of male osteoporosis. This is of particular importance as men have a higher morbidity and mortality following hip fractures than women. Orthopaedic surgeons should therefore take on responsibility for these fracture patients and ensure that the process of secondary prevention is initiated.
