One fracture is enough! Experience with a prospective and consecutive osteoporosis screening program with 239 fracture patients.

BACKGROUND: Fracture and low bone mineral density both have strong predictive value for future fractures. The risk of future fractures can be reduced by medi-cal treatment if patients with osteoporosis are identified, for example by screening fracture patients for low bone mineral density. We suggest that these screening routines be organized at orthopedics departments and we report our experience with such a screening system. PATIENTS AND METHODS: We screened all patients between 50-75 years of age with a wrist, vertebral, proximal humerus, or hip fracture visiting our orthopedics department by measuring bone mineral density (BMD) using DEXA scans. After diagnosis, the patients were referred to their primary care physician for treatment. RESULTS: Between November 1, 2002, and October 31, 2003, 239 patients were investigated and only 13% had normal BMD values. 45% of the patients were diagnosed with osteopenia and 42% with osteoporosis. INTERPRETATION: Screening of fracture patients who visit an orthopedics department appears to be an effective way of identifying individuals with low bone mineral density. The screening routines can be organized as an osteoporosis team consisting of a doctor, a nurse and a secretary at each department. Today, these patients are largely undetected and untreated--at least in our region. In our series, only 13 patients had been DEXA-scanned and were treated by antiresorptive drugs at the time of fracture.