The combined lifetime risk for hip, forearm, and vertebral fractures approximates 40% and is equivalent to the risk for cardiovascular disease.1 Approximately one in three women older than 50 years will experience osteoporotic fractures as will one in five men.2,3,4 Hip fractures, among the most common of fragility fractures, occur in over 4.5 million people worldwide yearly with an expected increase to 21 million persons living with disability in the next 40 years.5 Globally, the disability-adjusted life-years lost as a result of hip fractures rank in the top 10 of all-cause disability globally.6 Loss of life-years from hip fractures has been reported to range from 18% to as much as 58% of expected remaining years of life.7
Although tremendous advances have been made in identification, prevention, and management of osteoporosis, fractures associated with osteoporosis are increasingly managed by orthopaedic surgeons. Several key issues remain unanswered in the management of the osteoporotic patient with a fragility fracture. The current symposium brings together experts across North America, Europe, Australia, and Asia toward improved understanding of the long-term consequences of osteoporosis treatment, use of biologics in osteoporosis fracture management, optimal fixation approaches in multitrauma patients, periprosthetic fractures, and periarticular fractures. Gaps in knowledge and future questions are further discussed to guide ongoing research in fragility fracture management.
The opportunities to improve fragility fracture care are numerous. The current symposium provides as many questions as answers toward improved care and future experimental, biomechanical, and clinical research in the field.
Mohit Bhandari MD, PhD, FRCSC*‡
Emil H. Schemitsch MD, FRCSC†
1. Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk. Lancet
2. Melton LJ, 3rd, Chrischilles EA, Cooper C, et al. Perspective. How many women have osteoporosis? J Bone Miner Res
3. Kanis JA, Johnell O, Oden A, et al. Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int
4. Melton LJ, 3rd, Atkinson EJ, O'Connor MK, et al. Bone density and fracture risk in men. J Bone Miner Res
5. Schemitsch E, Bhandari M. Femoral Neck Fractures: Controversies and Evidence. J Orthop Trauma
6. Cooper C, Campion G, Melton LJ. Hip fractures in the elderly: a world-wide projection. Osteoporos Int
7. Vestergaard P, Rejnmark L, Mosekilde L. Loss of life years after a hip fracture. Acta Orthop