Observational studyArchives of orthopaedic and trauma surgery2026
Osteoporosis treatment gap prior to femoral fracture and prevalence of pharmacological risk factors: a prospective observational study.
Observational study in Archives of orthopaedic and trauma surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionHip fractures are a major complication of osteoporosis and are associated with high morbidity, mortality, and costs. Despite clear guideline recommendations, pharmacological osteoporosis treatment remains underutilized. In addition, medications that increase fall and fracture risk further contribute to fracture occurrence. The aim of this study was to assess guideline concordance of osteoporosis therapy and to quantify the prevalence of medications associated with increased fall and fracture risk prior to the fracture in patients admitted with femoral fractures. MATERIALS AND
methodsIn this prospective observational study, 145 patients aged ≥ 55 years admitted with femoral neck, per- and subtrochanteric, femoral shaft and distal femur fractures to a tertiary academic trauma center between April and June 2025 were included. Pre-admission medication was assessed using structured medication reconciliation. Guideline concordance of pre-fracture osteoporosis therapy was evaluated according to the current Austrian osteoporosis guideline (Dimai et al., 2024). Fall-risk-increasing drugs (FRIDs) were identified using the STOPPFall criteria, and fracture-associated medications were recorded based on Austrian osteoporosis guideline-defined drug classes.
resultsAmong 145 included patients (mean age 80.4 years; 71% female), 117 (81%) met criteria for pharmacological osteoporosis treatment prior to the fracture, defined by a preexisting osteoporosis diagnosis or a 10-year fracture risk above the treatment intervention threshold using the FRAX
conclusionsPatients presenting with femoral fractures demonstrate a substantial gap in guideline-concordant osteoporosis therapy and a high prevalence of medications associated with increased fall and fracture risk. These findings highlight important opportunities for systematic primary and secondary fracture prevention and structured medication review.
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