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Fragility fractures caused by osteoporosis, the most common metabolic bone disease, place a significant burden on affected individuals and impose substantial economic costs. A fragility fracture implies an imminent elevated risk for subsequent fractures, particularly in the short term. Therefore, osteoporosis must be addressed in the event of a sentinel fracture, if not already previously treated. Regardless of whether the fracture is treated conservatively or surgically, post-fracture care is particularly important. Early mobilization followed by fall risk assessment and the initiation of adequate bone-specific medication are essential milestones in preventing subsequent fractures. Monitoring patients increases adherence to bone-specific medication and fall prevention strategies. Comprehensive post-fracture care is important and should be performed by a multidisciplinary team. Coordinated care models, such as the fracture liaison service (FLS), have shown enhancements in the initiation of and adherence to secondary prevention of fragility fractures. Despite recommendations by several guidelines including that published by the Austrian Society for Bone and Mineral Research, only one fracture liaison service has been implemented in Austria., Competing Interests: Conflict of interest: K. Kerschan-Schindl, H. Widhalm, A. Pataraia, P. Nicolakis, M. Frossard, M. Keilani, M. Mickel, S. Hajdu, and R. Crevenna declare that they have no competing interests., (© 2024. The Author(s).)

Ten patients aged 55-85 years with a tibial head fracture AO B3 or C3 were treated primarily by implantation of an endoprosthesis. There were one unilateral, three superficial, and six revision-type prostheses. Follow-up was 6 months to 3 years; two patients were lost to follow-up. There were no intra- or postoperative complications except one deep infection which could be cured by repeated arthroscopic lavage. At last follow-up all eight patients were completely or almost pain free; the extension deficit was less than 10 degrees , and flexion was 100 degrees or more. Primary endoprosthetic replacement of the knee joint is a valuable procedure for the treatment of complex tibial head fractures in elderly patients.