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Risk Assessment, Prevention, and Treatment in Osteoporosis-Related Fractures

Teaser: 

Yan Gabriel Morais David Silva, MD,1 Ramon Guerra Barbosa, MD,2 Martin Kotochinsky, MD,3Lara Barbosa de Souza Moura Canas Lara, MS,4 Cloud Kennedy Couto de Sa, MD, PhD,5 Lucas Leal Varjão, MD,6 Kaike Lobo, MS,7 Eshita Sharma, MS,8Yasmin Picanço Silva, MD,9 Luis Fernando Weber de Oliveira, MD,10 Walter Fagundes, MD, PhD,11 Newton Godoy Pimenta, MD, PhD,12

1Spine Surgery - Hospital Ortopédico do Estado (Soc. Ben. Israelita Albert Einstein), Salvador, Bahia, Brazil.
2 Department of Neurosurgery, Hôpital de Chicoutimi, Quebec, Canada.

3 Department of Medicine, National University of Cuyo, Mendoza, Argentina.

4 State University of Feira de Santana (UEFS), Feira de Santana, Brazil.

5 Hospital Ortopédico do Estado (Soc. Ben. Israelita Albert Einstein), Salvador, Bahia, Brazil.
6 Hospital Ortopédico do Estado (Soc. Ben. Israelita Albert Einstein), Salvador, Bahia, Brazil.
7 State University of Pará, Belém, Brazil.
8 David Geffen School of Medicine at UCLA, Los Angeles, USA.
9 Healthcare Institution of South Iceland, Selfoss, Iceland.
10 Spine Surgery - Hospital Ortopédico do Estado (Soc. Ben. Israelita Albert Einstein), Salvador, Bahia, Brasil.
11 Department of Neurosurgery, Federal University of Espírito Santo, Espírito Santo, Vitória, Brazil.
12 Neurosurgery Division, University of Sherbrooke, Sherbrooke, Canada.

CLINICAL TOOLS

Abstract: Osteoporosis-related fractures represent a growing global health burden, requiring comprehensive strategies that span risk assessment, prevention, pharmacologic therapy, and surgical care. Dual-energy X-ray absorptiometry (DEXA) remains the diagnostic standard. However, fracture prediction improves when combined with clinical risk models, such as the Fracture Risk Assessment Tool (FRAX), QFracture, Garvan Risk Calculator, or a simplified assessment created by the Canadian Association of Radiologists and Osteoporosis Canada (CAROC). Effective prevention should be approached across the lifespan, maximizing peak bone mass in youth and attenuating later loss through lifestyle modifications. Pharmacologic therapy remains central to proper management while the treatment sequence, duration, and adverse effects necessitate individualized decision-making. In primary care, targeted screening of at-risk populations, systematic use of fracture risk calculators, prompt initiation of secondary prevention after sentinel fractures, and integration of multidisciplinary models are paramount.
Key Words: Osteoporosis, fragility fractures, DEXA, fracture risk calculators, pharmacologic therapy.

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www.cfpc.ca/Mainpro_M2

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Pre-test CME Quiz Post-test CME Quiz
Hip fractures in the elderly lead to a 17–30% one-year mortality.
The DEXA scan is the gold standard for identifying osteoporosis but fracture risk tools assist management.
Prevention includes early bone mass optimization; lifestyle measures and fall prevention in elderly.
Bisphosphonates are the first-line pharmacologic treatment.
Most vertebral fractures are treated conservatively; vertebroplasty/kyphoplasty should only be used for persistent pain.
About two thirds of vertebral fractures are silent so screening at-risk patients is important.
Calcium plus Vitamin D is more effective than calcium alone.
Fall-prevention strategies in the elderly such as balance, strength and environment modification reduce fracture risk more than drugs do.
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Related Terms: Back Health, osteoporosis, fragility fractures, DEXA, fracture risk calculators, pharmacologic therapy

Your Anger Won’t Fix Our Broken Healthcare System

Teaser: 

Dr. Alykhan Abdulla, BSC, MD, LMCC, CCFP, DipSportMed CASEM, FCFP, CTH (ISTM), CCPE, Masters Cert Phys Leader, ICD.D

is a comprehensive family doctor working in Manotick, Ontario, Board Director of the College of Family Physicians of Canada, Chair of the General Assembly at Ontario Medical Association and Director for Longitudinal Leadership Curriculum at the University of Ottawa Undergraduate Medical Education. Editor in Chief/Author Journal of Current Clinical Care SPORTS MEDICINE, Past Chair Section of General and Family Practice Ontario Medical Association, Bruyere Foundation

CLINICAL TOOLS

Abstract: Healthcare providers in Ottawa face unprecedented challenges with 165,000+ orphaned patients, hospital deficits, and record wait times. Despite operating at maximum capacity with 400+ daily calls and 500 weekly patients, staff endure abuse, racial slurs, and harsh criticism. Physician burnout threatens to worsen the crisis. This commentary urges patients to show kindness and understanding, emphasizing that healthcare workers are struggling within an overstretched system while maintaining their commitment to patient care.
Key Words: Physician burnout, patient abuse, healthcare crisis, compassionate care.
System Overwhelm: Ottawa has 165,000+ orphaned patients with hospitals operating at structural deficits, creating cascading delays across all healthcare services.
Operational Reality: Family practices handle 400+ daily calls and 500+ weekly patients, requiring complex triage and extended hours while managing impossible demand.
Staff Abuse Crisis: Healthcare workers face daily verbal abuse, racial slurs, and online harassment, accelerating burnout and threatening to worsen patient access.
Collaborative Solution: Patient kindness, realistic expectations, and trust in medical advice are essential to sustaining an overstretched healthcare system.
Triage Communication: When patients understand that ear infections and mental health crises require different response times, they’re more likely to accept appropriate care pathways and scheduling
Medication Management: Proactive patient self-monitoring of prescription refills and utilizing pharmacist renewal services can significantly reduce urgent appointment demands.
Burnout Prevention: Protecting healthcare staff from patient abuse is not just about workplace wellness—it’s a patient safety issue that directly impacts care access and quality.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Law and Ethics, Physician burnout, patient abuse, Healthcare crisis, compassionate care
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