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Undertreatment of Osteoporosis in Men Who Have Had a Hip Fracture—Reply
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In reply
Dr Abraham seems to imply that orthopedists may be culpable for the undertreatment of osteoporosis in patients with fracture. Patients with atraumatic fractures often have low bone mineral density1 and are at heightened risk for additional fractures.2 Orthopedists recognize that there is a window of opportunity to educate patients with fracture about osteoporosis and perhaps even initiate treatment.3 However, fracture repair is the immediate concern of the orthopedist. Patients often do not return to see their orthopedist after the fracture is healed; thus, it may be inappropriate for the orthopedist to initiate long-term treatment.
We would argue that there is plenty of culpability to go around. Cuddihy et al4 evaluated postfracture treatment of 343 women (mean age, 70 years). After 12 months, 83% had seen a nonorthopedic physician: the 12-month actuarial estimated cumulative incidence of any intervention for osteoporosis was only 18%. Thus, orthopedists are not the only . . . [Full Text of this Article]
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