{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:14:32Z","timestamp":1788545672708,"version":"build-2803163510"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n \n \n \u27a2 Fragility fracture care remains suboptimal worldwide despite strong evidence supporting timely surgery, orthogeriatric care, early mobilization, unrestricted weight-bearing, and secondary fracture prevention.<\/jats:p>\n <\/jats:list-item>\n \n \u27a2 International quality standards and registry-based audits have translated this evidence into measurable indicators that improve care in many high-income health-care systems.<\/jats:p>\n <\/jats:list-item>\n \n \u27a2 Implementation in low- and middle-income countries (LMICs) is limited primarily by health-system constraints, including workforce shortages, delayed presentation, limited infrastructure, and fragmented care pathways, rather than by lack of evidence.<\/jats:p>\n <\/jats:list-item>\n \n \u27a2 Emerging initiatives demonstrate that evidence-based quality standards can be successfully adapted to local contexts while preserving their core clinical principles.<\/jats:p>\n <\/jats:list-item>\n \n \u27a2 Orthopaedic surgeons have a central role in leading multidisciplinary care, promoting secondary fracture prevention, and driving quality improvement across the entire fragility fracture pathway.<\/jats:p>\n <\/jats:list-item>\n \n \u27a2 Future progress depends on strengthening health systems, embedding auditing and certification programs, and implementing context-sensitive quality standards that bridge the gap between evidence and routine.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>","DOI":"10.2106\/jbjs.26.00940","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:01:40Z","timestamp":1788544900000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Global Perspectives on the Care Gap in Fragility Fracture Management"],"prefix":"10.2106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5952-128X","authenticated-orcid":false,"given":"Irewin","family":"Tabu","sequence":"first","affiliation":[{"name":"Department of Orthopedics, University of the Philippines Manila, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5980-9697","authenticated-orcid":false,"given":"Elizabeth","family":"Armstrong","sequence":"additional","affiliation":[{"name":"School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3644-1388","authenticated-orcid":false,"given":"Matthew L.","family":"Costa","sequence":"additional","affiliation":[{"name":"Kadoorie Institute of Trauma, Emergency and Critical Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4811-669X","authenticated-orcid":false,"given":"Frede","family":"Frihagen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, \u00d8stfold Hospital Trust, Gr\u00e5lum, Norway"},{"name":"Institute of Clinical Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9221-5425","authenticated-orcid":false,"given":"Jay","family":"Magaziner","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4215-1689","authenticated-orcid":false,"given":"Joon-Kiong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Beacon Hospital, Petaling Jaya, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3056-6983","authenticated-orcid":false,"given":"Takeshi","family":"Sawaguchi","sequence":"additional","affiliation":[{"name":"Department of Traumatology, Fukushima Medical University, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"issue":"8","key":"bib1-20260904","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1016\/j.injury.2018.06.032","article-title":"International Collaboration of Orthopaedic Nursing (ICON); International Geriatric Fracture Society (IGFS); International Osteoporosis Foundation (IOF). 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