The word osteoporosis originates from the Greek language, meaning “porous bones”. It is often referred to as the “silent epidemic” in the sense that despite the fact it affects large numbers of individuals, it gives no warning signs and the first manifestation of the disease is in most cases a fracture. Usually a fragility fracture occurring after a fall from standing height, which would not normally cause any harm on a healthy, non osteoporotic individual.
Most osteoporotic or fragility fractures occur on the wrist, the vertebrae and the hip. The exact number of such fractures is largely unknown/underestimated.
Wrist fractures are usually managed conservatively, using a simple plaster cast and are therefore to a large extent unrecorded.
Vertebral fractures can be asymptomatic and diagnosis is placed only through x-rays of the spine. As a result the patient is unaware of the fracture(s).
Hip fractures on the other hand must be treated surgically, either by Dynamic Hip Screw (DHS) or Arthroplasty and require hospitalization. As a result hip fractures are properly recorded and form a reliable indicator of morbidity and mortality of osteoporosis.
Contrary to the common belief of patients and doctors, osteoporosis has high mortality mainly due to several complications as the underlying cause.
The deterioration of many health indicators caused by the financial crisis and the austerity measures have a direct impact on the osteoporotic patient’s compliance to the pharmaceutical treatment, which will inevitably lead to an increase of osteoporotic fractures.
The situation where an elderly couple arrives at the osteoporosis clinic for the annual bone densitometry of the wife and despite WHO recommendations the husband has never been undergone the same examination himself is a very common occurrence. When he does consent to have his DXA measurement the result usually indicates severe male osteoporosis, which is not rare, if properly seeked for.
Orthopedics is one of the few medical specialties involved in the diagnosis and treatment of osteoporosis. However the orthopedic surgeon is the only health professional who can follow up a patient before the fracture through diagnosis and treatment for primary fracture prevention, during fracture care either conservatively or surgically and after the fracture in rehabilitation, treatment follow up and secondary fracture prevention.