Osteoporosis is common in Americans older than age 50. This is often the cause of fragility fractures. Most fragility fractures of the vertebral body, proximal femur, and distal radius. In fact, more than 50 percent of women, and 30 percent of men will have a vertebral compression fracture at some point in their life. Ten to twenty percent will have another fragility fracture within one year following a vertebral fragility fracture.
There are several well-proven treatment options for osteoporosis. Treatment of osteoporosis with medication therapies can reduce the rate of subsequent fragility fracture by 50 percent. Morbidity following a fragility fracture is significant. The authors make the point that providers, particularly orthopedic surgeons, are missing opportunities to evaluate and treat osteoporosis following fragility fracture.
The authors of the study reviewed medical records from a military healthcare system with a computerized medical records data base. The authors were interested in evaluating intervention for evaluation and treatment of osteoporosis in the year following vertebral osteoporotic fragility fracture in patients 50 years or older. The records of 156 patients, 78 men and 78 women, meeting the inclusion criteria were evaluated. The authors were looking for referral for dual energy X-ray absorptiometry, DEXA scan, endocrinology, or prescribing of medications approved by the FDA for active treatment of osteoporosis.
The authors found that while sixty percent of women in the study were prescribed medications for active treatment of osteoporosis, only fifteen percent of men in the study were treated with medications for active treatment of osteoporosis. Forty seven percent of women were referred to endocrinology compared to 23 percent of the men. Additionally, 47 percent of women underwent DEXA scan compared to 31 percent of males.
The authors concluded that there is significant disparity among genders in the evaluation and treatment of osteoporosis following vertebral compression fracture. Given that the risk of subsequent fragility fractures following vertebral compression fracture in men is nearly double the risk in women, this gender disparity has even greater significance.