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Objective: The aim of this study was to report the prevalence of post-fracture bone mineral density (BMD) testing and osteoporosis treatment in patients admitted to the orthopedic department for low-energy or high-energy fractures and to identify factors affecting prevalence of post-fracture BMD testing and osteoporosis treatment., Methods: A total of 265 patients aged 45 years or older admitted with low-energy or high-energy fractures were reviewed between January 2010 and May 2011. Information regarding age, gender, fracture site and history of post-fracture BMD testing and osteoporosis treatment, including data reporting experiences of attending orthopedists (young: <10, senior: >10 years of experience) were recorded., Results: Of the 265 patients (175 female, 90 male), 259 (97.7%) patients had low-energy fractures and 6 (2.3%) suffered high-energy fractures. Of 259 low-energy fractures, 99 (38.2%) underwent BMD testing and had mean total T-scores of -2.04±1.01 (proximal-femur) and -2.12±1.27 (lumbar-spine). Only one high-energy fracture patient (16.7%) underwent BMD testing, with a T-score of -1.1 (proximal-femur) and -2.7 (lumbar-spine). Eighty-six (32.5%) patients (85 low-energy fractures; 1 high-energy fracture) with diagnosis of osteopenia/osteoporosis from BMD testing were treated with calcium, vitamin D, and bisphosphonates. Bone mineral density testing was significantly higher in low-energy fracture patients who were treated by a young orthopedist, a common fracture site (proximal-femur, distal-radius, vertebrae) or were female (p<0.05)., Conclusion: Bone mineral density investigation and treatment rates are currently suboptimal. The current gap in adequate care necessitates multidisciplinary intervention in order to lessen the incidence of future fractures, particularly in patients over the age of 45.

Objectives: The purpose of this study was to determine which of the predisposing risk factors for the first hip fracture would continue to be effective for the development of the second hip fracture in the elderly., Methods: Data of 125 patients (31 men, 94 women) aged 55 years or older were evaluated, who sustained first (group 1, n=97) and second contralateral (group 2, n=28) hip fracture. Patients who were treated with bisphosphonate, calcitonin, and estrogen were not included., Results: The incidence of the second hip fracture was higher (78.6%) beyond 12 months of the first fracture. The risk for sustaining a second hip fracture was 3.96-fold greater in patients over 85 years of age (p<0.05). Among comorbid medical conditions, eye diseases (p=0.02) and neurological diseases (p=0.048) were significantly more frequent in group 2. There was an obvious relationship between the second hip fracture and lower Singh index grades of = or < 3 (p<0.001). Patients over 85 years of age and having a lower Singh index grade were found to have a 6.57-fold increased risk for developing a second hip fracture (95% CI: 2.13-20.3; p=0.001). In univariate analysis, neurological diseases represented a significantly increased risk. Eye diseases were highly associated with an increased risk for second hip fractures in univariate (OR: 3.3, 95% CI: 1.2-9.2, p=0.020) and multivariate (OR: 7.6, 95% CI: 1.9-30.7, p=0.004) analyses. The Singh index of grade = or < 3 showed the highest associations with second hip fractures in both univariate (OR: 18.9, 95% CI: 5.8-65.9, p<0.001) and multivariate (OR: 30.00, 95% CI: 7.9-112.9, p<0.001) analyses., Conclusion: We concluded that, of all the risk factors for the first hip fractures, only hypotrophic changes in the proximal femoral trabeculae, eye diseases, and neurological diseases acted as major risk factors for the second contralateral hip fractures in the elderly.