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The interplay of the three major bone cells \u2013 osteoblasts, osteoclasts, and osteocytes \u2013 is normally well regulated via the secretion of messengers to control bone remodeling. Possible imbalances that might occur in the elderly are partly due to age, genetic risk factors, and adverse lifestyle factors but importantly also due to imbalances in calcium homeostasis (mostly due to vitamin D deficiency or hypochlorhydria), which have to be eliminated. Therefore, the cooperation between the trauma surgeon and the osteologist is of major importance to diagnose and treat the respective patients at risk. We propose that any patient suffering from fragility fractures is rigorously screened for osteoporosis and metabolic bone diseases. This includes bone density measurement by dual-energy X-ray absorptiometry, laboratory tests for calcium, phosphate, vitamin D, and bone turnover markers, as well as additional diagnostic modalities if needed. Thereby, most risk factors, including vitamin D deficiency, can be identified and treated while patients who meet the criteria for a specific therapy (i.e. antiresorptive and osteoanabolic) receive such. If local health systems succeed to manage this process of secondary fracture prevention, morbidity and mortality of fragility fractures will decline to a minimum level.<\/jats:p>","DOI":"10.1515\/iss-2016-0025","type":"journal-article","created":{"date-parts":[[2016,12,8]],"date-time":"2016-12-08T05:01:05Z","timestamp":1481173265000},"page":"49-55","source":"Crossref","is-referenced-by-count":1,"title":["Bone biology in the elderly: clinical importance for fracture treatment"],"prefix":"10.1515","volume":"1","author":[{"given":"Tim","family":"Rolvien","sequence":"first","affiliation":[{"name":"Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Amling","sequence":"additional","affiliation":[{"name":"Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2016,12,8]]},"reference":[{"key":"2026030213541913614_j_iss-2016-0025_ref_001_w2aab3b7c17b1b6b1ab2b3b1Aa","doi-asserted-by":"crossref","unstructured":"van den Bergh JP, van Geel TA, Geusens PP. 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