A low-energy fracture of the hip, spine, wrist or proximal humerus in an older adult is a strong predictor of further fracture, with the risk highest in the first year or two. Many patients leave the fracture service without assessment or treatment for osteoporosis.
Record the fracture as a fragility fracture, check calcium and vitamin D status, and start or refer for bone protection before discharge, through a fracture liaison service where one exists.
- Label low-energy fractures as fragility fractures in the discharge summary.
- Check calcium, vitamin D and renal function before starting treatment.
- Start or refer for osteoporosis treatment before the patient leaves.
- Assess falls risk at the same time.
Why it matters
The fracture clinic is often the only point at which an older patient's osteoporosis is visible to anyone.
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