Abstract
Osteoporosis is common in elderly patients and is commonly associated with fractures of the neck of the femur. It is known that this condition is not treated optimally by orthopaedic services around the world. We aim to examine the level of osteoporosis treatment in this fracture and how effective we were in improving treatment for osteoporosis.
We retrospectively examined hospital documents from patients admitted between 1 January and 31 December 2004 with femoral neck fracture. All notes were retrieved and were complete. We examined the medications on admission, the place of residence, place of discharge, frequency of DEXA scanning and medications.
One hundred and twenty patients were admitted with fracture of the neck of the femur. This group consisted of 23 males with an average age of 76.7, 97 females with an average age of 83.7. Seventy five of these patients were admitted from home, 45 from a rest home. Four patients died prior to treatment, one refused treatment and subsequently died in a hospice. Osteoporotic medications on admission showed that 13 patients were on Bisphosphonate, 6 on Vitamin D and twelve on calcium supplements. Only 14 patients had had DEXA scans prior to admission. On admission eight patients were on no medications of any sort, 53 were on 1–4 medications, 53 were on 5–9 medications and 6 were on greater than 10 medications. On discharge from orthopaedic of the 120 patients 13 were on Bisphosphonate, six on Vitamin D, 13 on calcium supplements. Six patients were on no medications, 47 on 1–4 medications, 55 on 5–9 medications, nine on greater than 10 medications. On discharge from geriatric service, to which 69 patients had been referred 25 were on Bisphosphonate, 13 on Vitamin D, 18 on calcium supplements. One patient was on no medication. 20 were on 1–4 medications, 41 on 5–9 medications and seven on greater than 10 medications. Fifty four had had DEXA scans.
We found that the rate of treatment of osteoporosis in the community remains poor with no improvement while in the orthopaedic service.
On discharge from the geriatric service significant improvement in osteoporotic medication occurred but there was also an increased in polypharmacy.
Further work on the investigation and treatment of osteoporosis in this country is required.
Correspondence should be addressed to Associate Professor N. Susan Stott, Orthopaedic Department, Starship Children’s Hospital, Private Bag 92024, Auckland, New Zealand.
