Most fractures associated with osteoporosis have occurred due to progressive weakening of the bone. This is also associated with generalized weakening of the bones elsewhere in the body, particularly the spine and the wrist.
So, any patient of osteoporosis presenting with fracture must be carefully assessed for fragility fractures elsewhere.
The second point of concern is, osteoporosis worsens with inactivity. So these patients must be made ambulatory at the earliest possible.
The third issue is regarding the stability of fixation, in such fractures. Osteoporotic bones are typically too soft to provide strong anchorage to screws and plates. This may be addressed either by using the newer locking plates or by cement augmentation of the standard screws and plates.
In patients with osteoporotic fractures, the treatment of osteoporosis must continue along with the care of fracture. This includes drugs like bisphosphonates, teri-paratide (forteo), calcitonin, calcium and vitamin D supplements. Adequate bracing should be done to the areas at risk of fragility fractures.
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