Secondary prevention of fragility fractures by orthopaedic teams in the UK: a national survey

Abstract

OBJECTIVE: To assess secondary prevention of fragility fractures by orthopaedic surgeons in the UK and study the effect of multidisciplinary approach in providing secondary prevention. METHODS: A survey was conducted consisting of a postal questionnaire sent to 1000 UK orthopaedic surgeons. 750 valid responses were received. RESULTS: The survey revealed poor compliance with existing guidelines. In the 60- to 80-year age group, the presence of a fracture liaison nurse made a significant difference in the prescription of vitamin D and calcium, providing weight bearing advice, fall risk assessment and dual energy x-ray absorptiometry (DEXA) scan requests. Orthogeriatric service made a significant difference in providing weight bearing advice and DEXA scan requests. In the above 80-year age group, fracture liaison nurses made a significant difference in provision of fall risk assessment and weight bearing advice. Orthogeriatric services made a significant difference in prescribing vitamin D and calcium, providing weight bearing advice and for DEXA scan requests. CONCLUSION: The study re-emphasises the inadequate initiation of secondary preventive measures by orthopaedic units. It also highlights the importance of orthogeriatric and fracture liaison nurse services in improving compliance with existing guidelines.