Older people with frailty, non-weight bearing after lower limb fracture should have bone mineral density assessment before being offered specific drug treatment for osteoporosis.
if you are health professionals who work with facility fractures, do you agree or disagree with the above statement, and why?
Dear Saleh
The lower limb fracture in older people (osteoporotic fracture - silent disease) is an orthopedic emergency and in the great majority of the cases the treatment is surgical. After the orthopedic surgery the bone mineral density should be evaluated and the drug therapy is started, The most frequent drug is bisphosphonate and can be associated with vitamin D
Most of the cases are considered as emergency. No doubt about the importance of doing DEXA scan for those group of patients. The point here is when to start bisphosphontes, which inhibit the osteoclastic activity that is needed to clean the fracture sites during the early stages of healing. 3 or 4 weeks after fracture is a reasonable timing. Another important issue is the anticoagulation prophylaxis.
when entering an Emergency room, it is assessed by a team made up of a geriatrician or, instead, an internist or a family doctor with training in Geriatrics, a rehabilitation doctor, an anesthesiologist and the orthopedist, which could be called GERIATRIC CARE GROUP (GCG), with a therapeutic objective to reincorporate the patient as soon as possible to the activities of daily living. In the same way, it is recommended that it should be intervened in the first 48 hours by the treating team and as elective surgery, not as an emergency
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