Diagnosis and Treatment of Osteoporosis Following Hip Fracture in Chiang Mai University Hospital
Sattaya Rojanasthien, MD*, Siripong Chiewchantanakit, MD*, Tanawat Vaseenon, MD*
Affiliation : * Department of Orthopaedics, Faculty of Medicine,Chiang Mai University, Chiang Mai
Background : Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength
predisposing a person to an increased risk of fracture. Hip fracture is the common and serious consequence of
osteoporosis. To improve bone quality and prevent new fracture, osteoporosis should be treated while the
patient was admitted with hip fracture problem. Several medications have been proven to be effective. Objec-
tives of the present study were to determine the adequacy of diagnosis and treatment of osteoporosis in hip
fracture patients.
Materials and Methods : A retrospective study of all low energy trauma hip fracture patients, between 1998 and
2003 at the age of 50 years old or more.The National Osteoporosis Foundation guideline was used to identify
adequacy of diagnosis and treatment of osteoporosis in this group of patients.Age,sex,admitted
diagnosis,mechanism of injury,admission medication,treatment procedures,discharge medication,BMD in-
vestigation were analysed.
Results : The percentage of calcium supplementation for the discharged patients in 1998 to 2003 was 0%,
10.5%, 33.3%, 32.7%, 39.3% and 43.0% respectively. The percentage of combination of calcium and vitamin
D supplementation for the discharged patients was 0%, 8.8%, 21.1%, 12.7%, 24.6% and 37.5% respectively.
Bisphosphonate was ordered in 9 and calcitonin in 20 patients. 7% of patients were diagnosied as
osteoporosis.The quantity of osteoporosis was confirmed by DXA measurement in only one patient.
Conclusions : In the past 6 years, most of the hip fracture patients were underdiagnosed and undertreated for
osteoporosis. There was also a good trend for better treatment.
Keywords : Hip fracture, Diagnosis, Treatment
