{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T18:22:46Z","timestamp":1771870966344,"version":"3.50.1"},"reference-count":20,"publisher":"Royal College of Surgeons of England","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2006,9]]},"abstract":"<jats:sec><jats:title>INTRODUCTION<\/jats:title><jats:p> The aim of this study was to determine whether orthopaedic surgeons follow the British Orthopaedic Association (BOA) guidelines for secondary prevention of fragility fractures. <\/jats:p><\/jats:sec><jats:sec><jats:title>PATIENTS AND METHODS<\/jats:title><jats:p> A retrospective audit was conducted on patients with neck of femur fractures treated in our hospital between October and November 2003. A re-audit was conducted during the period August to October 2004. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> There were 27 patients in the initial study period. Twenty-six patients (96%)had full blood count measured with LFT and bone-profile measured in 18 patients (66%). Only nine patients (30%)had treatment for osteoporosis (calcium and vitamin D). Only one patient was referred for DEXA scan. Steps were taken in the form of creating better awareness among the junior doctors and nurse practitioners of the BOA guidelines. In patients above 80 years of age, it was decided to use abbreviated mental score above 7 as a clinical criteria for DEXA referral. A hospital protocol based on BOA guidelines was made. A re-audit was conducted during the period August to October 2004. There were 37 patients. All had their full blood count and renal profile checked (100%). The bone-profile was measured in 28 (75.7%) and LFT in 34 (91.9%)patients. Twenty-four patients (65%) received treatment in the form of calcium + vitamin D (20) and bisphosphonate (4). DEXA-scan referral was not indicated in 14 patients as 4 were already on bisphosphonates and for 10 patients their abbreviated mental score was less than 7. Among the remaining 23 patients, 9 patients (40%) were referred for DEXA scan. This improvement is statistically significant (P = 0.03, chi square test). <\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSION AND CONCLUSIONS<\/jats:title><jats:p> The re-audit shows that, although there is an improvement in the situation, we are still below the standards of secondary prevention of fragility fractures with 60% of femoral fragility fracture patients not being referred for DEXA scan. A pathway lead by a fracture liaison nurse dedicated to osteoporotic fracture patients should improve the situation. <\/jats:p><\/jats:sec>","DOI":"10.1308\/003588406x116891","type":"journal-article","created":{"date-parts":[[2006,9,18]],"date-time":"2006-09-18T22:46:17Z","timestamp":1158619577000},"page":"470-474","source":"Crossref","is-referenced-by-count":35,"title":["Secondary Prevention of Fragility Fractures: Are We Following the Guidelines?"],"prefix":"10.1308","volume":"88","author":[{"given":"N","family":"Prasad","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedics, Royal Glamorgan Hospital Llantrisant, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Sunderamoorthy","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Royal Glamorgan Hospital Llantrisant, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Royal Glamorgan Hospital Llantrisant, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JM","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Royal Glamorgan Hospital Llantrisant, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"171","reference":[{"key":"b2","volume-title":"Osteoporosis: clinical guidelines for prevention and treatment","author":"The Royal College of Physicians","year":"2001"},{"key":"b3","volume-title":"The care of fragility fracture patients","author":"British Orthopaedic Association","year":"2003"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.319.7221.1350"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-003-1514-0"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.3.320"},{"key":"b7","volume-title":"Management of osteoporosis: a national clinical guideline","author":"Scottish Inter-Collegiate Guidelines Network","year":"2003"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.1007\/s001980050107"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.1007\/PL00004148"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)07088-2"},{"key":"b11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200102013440503"},{"key":"b12","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.14.1344"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.1007\/s001980050010"},{"key":"b14","volume-title":"Assessment of fracture risk and its application to screening for post-menopausal osteoporosis","author":"World Health Organization","year":"1994"},{"key":"b15","doi-asserted-by":"publisher","DOI":"10.1007\/s001980170006"},{"key":"b16","doi-asserted-by":"publisher","DOI":"10.1258\/136218001100321290"},{"key":"b17","doi-asserted-by":"publisher","DOI":"10.3310\/hta6290"},{"key":"b18","doi-asserted-by":"publisher","DOI":"10.1308\/147870804371"},{"key":"b19","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2003.10.017"},{"key":"b20","volume-title":"NICE Technology Appraisal Guidance 87","author":"National Institute for Clinical Excellence","year":"2005"},{"key":"b21","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-003-1507-z"}],"container-title":["The Annals of The Royal College of Surgeons of England"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/pdf\/10.1308\/003588406X116891","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T10:11:43Z","timestamp":1684145503000},"score":1,"resource":{"primary":{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/10.1308\/003588406X116891"}},"subtitle":["Closing the Audit Loop"],"short-title":[],"issued":{"date-parts":[[2006,9]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2006,9]]}},"alternative-id":["10.1308\/003588406X116891"],"URL":"https:\/\/doi.org\/10.1308\/003588406x116891","relation":{},"ISSN":["0035-8843","1478-7083"],"issn-type":[{"value":"0035-8843","type":"print"},{"value":"1478-7083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,9]]}}}