A Guide to Improving the Care of Patients With Fragility Fractures

Burge R Dawson-Hughes B Solomon DH (2007). Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res, 22(3):465–475.

Melton LJ 3rd Crowson CS O’Fallon WM. (1999). Fracture incidence in Olmsted County, Minnesota: comparison of urban with rural rates and changes in urban rates over time. Osteoporos Int, 9(1):29–37.

Agency for Healthcare Research and Quality. 2005 HCUP Nationwide Inpatient Sample (NIS) Comparison Report. Rockville, MD: US Department of Health and Human Services; 2008.

Cummings SR Melton LJ. (2002). Epidemiology and outcomes of osteoporotic fractures. Lancet, 359(9319):1761–1767.

US Department of Health and Human Services. The 2004 Surgeon General’s Report on Bone Health and Osteoporosis. http://www.surgeongeneral.gov/library/bonehealth/docs/OsteoBrochure1mar05.pdf. Accessed October 12, 2010.

Frey WH ; National Center for Health Statistics. Teaching/training modules on trends in health and aging. http://www.asaging.org/nchs/. Accessed November 15, 2010.

US Department of Health and Human Services. The 2004 Surgeon General’s report on bone health and osteoporosis. http://www.surgeongeneral.gov/library/bonehealth/docs/OsteoBrochure1mar05.pdf. Accessed October 12, 2010.

Su H Aharonoff GB Zuckerman JD Egol KA Koval KJ . The relation between discharge hemoglobin and outcome after hip fracture. Am J Orthop (Belle Mead NJ). 2004;33(11):576–580.

Ekman EF . The role of the orthopaedic surgeon in minimizing mortality and morbidity associated with fragility fractures. J Am Acad Orthop Surg. 2010;18(5):278–285.

Kates SL Blake D Bingham KW Comparison of an organized geriatric fracture program to United States government data. J Geratir Orth Surg. 2010;1(1):15–21.

British Orthopaedic Association. The Care of Patients With Fragility Fracture. London: British Orthopaedic Association; 2007.

Agency for Healthcare Research and Quality. 2005 HCUP Nationwide Inpatient Sample (NIS) Comparison Report. Rockville, MD: US Department of Health and Human Services; 2008.

Braithwaite RS Col NF Wong JB . Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc. 2003;51(3):364–370.

Youm T Koval KJ Zuckerman JD . The economic impact of geriatric hip fractures. Am J Orthop. 1999;28(7):423–428.

DeFrances CJ Lucas CA Buie VC , Golosinskiy A. 2006 National hospital discharge survey. Natl Health Stat Report. 2008;5:1–20.

Inouye SK . Delirium in hospitalized older patients: recognition and risk factors. J Geriatr Psychiatry Neurol. 1998;11(3):118–125; discussion 157-158.

Robertson BD Robertson TJ . Postoperative delirium after hip fracture. J Bone Joint Surg Am. 2006;88(9):2060–2068.

Friedman SM Mendelson DA Bingham KW Kates SL . Impact of a comanaged Geriatric Fracture Center on short-term hip fracture outcomes. Arch Intern Med. 2009;169(18):1712–1717.

Friedman SM Mendelson DA Kates SL McCann RM . Geriatric co-management of proximal femur fractures: total quality management and protocol-driven care result in better outcomes for a frail patient population. J Am Geriatr Soc. 2008;56(7):1349–1356.

Simunovic N Devereaux PJ , Sprague S, et al. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. CMAJ. 2010;182(15):16 09-1616.

Orosz GM Magaziner J Hannan EL . Association of timing of surgery for hip fracture and patient outcomes. JAMA. 2004;291(14):1738–1743.

Al-Ani AN Samuelsson B Tidermark J Early operation on patients with a hip fracture improved the ability to return to independent living: a prospective study of 850 patients. J Bone Joint Surg Am. 2008;90(7):1436–1442.

Marsland D Mears SC Kates SL . Venous thromboembolic prophylaxis for hip fractures. Osteoporos Int. 2010;21 (suppl 4):S593–S604.

Wallace AW Au S Cason BA . Association of the pattern of use of perioperative beta-blockade and postoperative mortality. Anesthesiology. 2010;113(4):794–805.

Rodgers A Walker N Schug S . Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ. 2000;321(7275):1493–1497.

Urwin SC Parker MJ Griffiths R . General versus regional anaesthesia for hip fracture surgery: a meta-analysis of randomized trials. Br J Anaesth. 2000;84(4):450–455.

Bryson GL Wyand A . Evidence-based clinical update: general anesthesia and the risk of delirium and postoperative cognitive dysfunction. Can J Anaesth. 2006;53(7):669–677.

Vanzetto G Machecourt J Blendea D Additive value of thallium single-photon emission computed tomography myocardial imaging for prediction of perioperative events in clinically selected high cardiac risk patients having abdominal aortic surgery. Am J Cardiol. 1996;77(2):143–148.

Sieber FE Zakriya KJ Gottschalk A Sedation depth during spinal anesthesia and the development of postoperative delirium in elderly patients undergoing hip fracture repair [erratum in Mayo Clin Proc. 2010;85(4):400]. Mayo Clin Proc. 2010;85(1):18–26.

Marcantonio ER Goldman L Orav EJ Cook EF Lee TH . The association of intraoperative factors with the development of postoperative delirium. Am J Med. 1998;105(5):380–384.

Williams-Russo P Sharrock NE Mattis S Randomized trial of hypotensive epidural anesthesia in older adults. Anesthesiology. 1999;91(4):926–935.

Yocum GT Gaudet JG Teverbaugh LA Neurocognitive performance in hypertensive patients after spine surgery. Anesthesiology. 2009;110(2):254–261.

Lowell JD . Fractures of the hip. N Engl J Med. 1966;274(26):1480–1490.

Raaymakers ELFB . The non-operative treatment of impacted femoral neck fractures. Injury. 2002;33(Suppl 3):S-C8–S-C14.

Oakey JW Stover MD Summers HD Does screw configuration affect subtrochanteric fracture after femoral neck fixation? Clin Orthop Relat Res. 2006;443:302–306.

Lee KB Howe TS Chang HC . Cancellous screw fixation for femoral neck fractures: one hundred and sixteen patients. Ann Acad Med Singapore. 2004;33(2):248–251.

Rogmark C Carlsson A Johnell O Sernbo I . A prospective randomised trial of internal fixation versus arthroplasty for displaced fractures of the neck of the femur: functional outcome for 450 patients at two years. J Bone Joint Surg Br. 2002;84(2): 183–188.

Parker MJ Gurusamy K . Arthroplasties (with and without bone cement) for proximal femoral fractures in adults. Cochrane Database Syst Rev. 2006;(3):1–65.

Parker MJ Gurusamy KS Azegami S . Arthroplasties (with and without bone cement) for proximal femoral fractures in adults. Cochrane Database Syst Rev. 2010;(6):CD001706.

Raia FJ Chapman CB Herrera MF Unipolar or bipolar hemiarthroplasty for femoral neck fractures in the elderly? Clin Orthop Relat Res. 2003;414:259–265.

Baker RP Squires B Gargan MF Bannister GC . Total hip arthroplasty and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck: a randomized, controlled trial. J Bone Joint Surg Am. 2006;88(12):2583–2589.

Blomfeldt R Tornkvist H Eriksson K A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients. J Bone Joint Surg Br. 2007;89(2):160–165.

Muller ME Nazarian S Koch P Schatzker J . The Comprehensive Classification of Fractures of Long Bones. Berlin: Springer-Verlag; 1990.

Gotfried Y . Integrity of the lateral femoral wall in intertrochanteric hip fractures: an important predictor of a reoperation [letter]. J Bone Joint Surg Am. 2007;89(11):2552–2553; author reply 2553.

Baumgaertner MR Curtin SL Lindskog DM Keggi JM . The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip. J Bone Joint Surg Am. 1995;77(7):1058–1064.

Haidukewych GJ Israel TA Berry DJ . Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg Am. 2001;83(5):643–650.

Bojan AJ Beimel C , Speitling A, et al. 3066 Consecutive Gamma Nails: 12 years experience at a single centre. BMC Musculoskelet Disord. 2010;11:133.

Koval KJ Sala DA Kummer FJ Zuckerman JD . Postoperative weight-bearing after a fracture of the femoral neck or an intertrochanteric fracture. J Bone Joint Surg Am. 1998;80(3):352–356.

Hoffmann R Haas NP . Femur: proximal. In: Ruedi TP Murphy WM , eds. AO Principles of Fracture Management. New York: Thieme; 2000:441–454.

Gibson SJ Helme RD . Age-related differences in pain perception and report. Clin Geriatr Med. 2001;17(3):433–456.

Chai E Horton JR . Managing pain in the elderly population: pearls and pitfalls. Curr Pain Headache Rep. 2010;14(6):409–417.

Hadjistavropoulos T Herr K Turk DC An interdisciplinary expert consensus statement on assessment of pain in older persons. Clin J Pain. 2007;23(suppl):S1–S43.

Matot I Oppenheim-Eden A Ratrot R Preoperative cardiac events in elderly patients with hip fracture randomized to epidural or conventional analgesia. Anesthesiology. 2003;98(1):156–163.

Scheinin H Virtanen T Kentala E Epidural infusion of bupivacaine and fentanyl reduces perioperative myocardial ischaemia in elderly patients with hip fracture: a randomized controlled trial. Acta Anaesthesiol Scand. 2000;44(9):1061–1070.

Parker MJ Griffiths R Appadu B . Nerve blocks (subcostal, lateral cutaneous, femoral, triple, psoas) for hip fractures. Cochrane Database Syst Rev. 2002;(1):CD001159.

Egbert AM . Postoperative pain management in the frail elderly. Clin Geriatr Med. 1996;12(3):583–599.

Juliebo V Bjoro K Krogseth M Risk factors for preoperative and postoperative delirium in elderly patients with hip fracture. J Am Geriatr Soc. 2009;57(8):1354–1361.

Morrison RS Magaziner J McLaughlin MA The impact of post-operative pain on outcomes following hip fracture. Pain. 2003;103(3):303–311.

Seitz DP Gill SS van Zyl LT . Antipsychotics in the treatment of delirium: a systematic review. J Clin Psychiatry. 2007;68(1):11–21.

Eriksson P Boman K Jacobsson B Olofsson BO . Cardiac arrhythmias in familial amyloid polyneuropathy during anaesthesia. Acta Anaesthesiol Scand. 1986;30(4):317–320.

Stockl KM Le L Zhang S Harada ASM . Clinical and economic outcomes associated with potentially inappropriate prescribing in the elderly. Am J Manag Care. 2010;16(1):e1–e10.

Leung JM Sands LP Paul S Does postoperative delirium limit the use of patient-controlled analgesia in older surgical patients? Anesthesiology. 2009;111(3):625–631.

Aubrun F Marmion F . The elderly patient and postoperative pain treatment. Best Pract Res Clin Anaesthesiol. 2007;21(1):109–127.

Gilron I Orr E Tu D Mercer CD Bond D . A randomized, double-blind, controlled trial of perioperative administration of gabapentin, meloxicam and their combination for spontaneous and movement-evoked pain after ambulatory laparoscopic cholecystectomy. Anesth Analg. 2009;108(2):623–630.

White PF Sacan O Tufanogullari B Effect of short-term postoperative celecoxib administration on patient outcome after outpatient laparoscopic surgery. Can J Anaesth. 2007;54(5):342–348.

Marret E Kurdi O Zufferey P Bonnet F . Effects of nonsteroidal antiinflammatory drugs on patient-controlled analgesia morphine side effects: meta-analysis of randomized controlled trials. Anesthesiology. 2005;102(6):1249–1260.

Pereira J Lawlor P Vigano A Dorgan M Bruera E . Equianalgesic dose ratios for opioids: a critical review and proposals for long-term dosing. J Pain Symptom Manage. 2001;22(2):672–687.

Kakar S Tornetta P III Schemitsch EH Technical considerations in the operative management of femoral neck fractures in elderly patients: a multinational survey. J Trauma. 2007;63(3):641–646.

Parker MJ Livingstone V Clifton R McKee A . Closed suction surgical wound drainage after orthopaedic surgery. Cochrane Database Syst Rev. 2007;(4):CD001825.

Rizvi AA Chillag SA Chillag KJ . Perioperative management of diabetes and hyperglycemia in patients undergoing orthopaedic surgery. J Am Acad Orthop Surg. 2010;18(7):426–435.

Edwards C Counsell A Boulton C Moran CG . Early infection after hip fracture surgery: risk factors, costs and outcome. J Bone Joint Surg Br. 2008;90(6):770–777.

Comfort EH . Reducing pressure ulcer incidence through Braden Scale risk assessment and support surface use. Adv Skin Wound Care. 2008;21(7):330–334.

Remaley DT Jaeblon T . Pressure ulcers in orthopaedics. J Am Acad Orthop Surg. 2010;18(9):568–575.

Fisher CG Blachut PA Salvian AJ Meek RN O’Brien PJ . Effectiveness of pneumatic leg compression devices for the prevention of thromboembolic disease in orthopaedic trauma patients: a prospective, randomized study of compression alone versus no prophylaxis. J Orthop Trauma. 1995;9(1):1–7.

Handoll HHG Farrar MJ McBirnie J . Heparin, low molecular weight heparin and physical methods for preventing deep vein thrombosis and pulmonary embolism following surgery for hip fractures. Cochrane Database Syst Rev. 2002;(4):CD000305.

National Institute for Health and Clinical Excellence. Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital. Clinical Guideline 92. http://www.nice.org.uk/guidance/index.jsp?action=byID&o=12695. Accessed May 7, 2010.

Kaiser MJ Bandinelli S Lunenfeld B . Frailty and the role of nutrition in older people: a review of the current literature. Acta Biomed. 2010;81 (suppl 1):37–45.

Pioli G Barone A Giusti A Predictors of mortality after hip fracture: results from 1-year follow-up. Aging Clin Exp Res. 2006;18(5):381–387.

Sanchez-Reilly SE . Nutrition. In: Soriano R , ed. Fundamentals of Geriatric Medicine: A Case-Based Approach. New York: Springer; 2007:177–191.

Handoll HHG Cameron ID Mak JCS Finnegan TP . Multidisciplinary rehabilitation for older people with hip fractures. Cochrane Database Syst Rev. 2009;(4):CD007125.

Schnell S Friedman SM Mendelson DA Bingham KW Kates SL . The 1-year mortality of patients treated in a hip fracture program for elders. Geriatr Orthop Surg Rehabil. 2010;1(1):6–14.

Dell R Greene D Schelkun SR Williams K . Osteoporosis disease management: the role of the orthopaedic surgeon. J Bone Joint Surg Am. 2008;90 (suppl 4):188–194.

Barrett JA Baron JA Karagas MR Beach ML . Fracture risk in the U.S. Medicare population. J Clin Epidemiol. 1999;52(3):243–249.

Hettrich CM Boraiah S Dyke JP Quantitative assessment of the vascularity of the proximal part of the humerus. J Bone Joint Surg Am. 2010;92(4):943–948.

Neer CS II. , II: treatment of three-part and four-part displacement. J Bone Joint Surg Am. 1970;52:1090–1103.

Neer CS II. , I: classification and evaluation. J Bone Joint Surg Am. 1970;52(6):1077–1089.

Codman EA. : The Shoulder Rupture of the Supraspinatus Tendon and Other Lesions in or About the Subacromial Bursa. Boston: Thomas Todd; 1934:313–331.

Hertel R Hempfing A Stiehler M Leunig M . Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elbow Surg. 2004;13(4):427–433.

Orthopaedic Trauma Association Committee for Coding and Classification. Fracture and dislocation compendium. J Orthop Trauma. 1996;10:v–154.

Hawkins RJ . Unrecognized dislocations of the shoulder. Instr Course Lect. 1985;34:258–263.

Court-Brown CM Garg A McQueen MM . The translated two-part fracture of the proximal humerus: epidemiology and outcome in the older patient. J Bone Joint Surg Br. 2001;83(6):799–804.

Dimakopoulos P Panagopoulos A Kasimatis G . Transosseous suture fixation of proximal humeral fractures: surgical technique. J Bone Joint Surg Am. 2009;91 (suppl 2, pt 1):8–21.

Wachtl SW Marti CB Hoogewoud HM Jakob RP Gautier E . Treatment of proximal humerus fracture using multiple intramedullary flexible nails. Arch Orthop Trauma Surg. 2000;120 (3-4):171–175.

Konrad G Bayer J Hepp P Open reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate: surgical technique. J Bone Joint Surg Am. 2010;92 (suppl 1, pt 1):85–95.

Owsley KC Gorczyca JT . Fracture displacement and screw cutout after open reduction and locked plate fixation of proximal humeral fractures [corrected]. J Bone Joint Surg Am. 2008;90(2):233–24091.

Guy P Slobogean GP McCormack RG . Treatment preferences for displaced three- and four-part proximal humerus fractures. J Orthop Trauma. 2010;24(4):250–25492.

Cazeneuve JF Cristofari DJ . The reverse shoulder prosthesis in the treatment of fractures of the proximal humerus in the elderly. J Bone Joint Surg Br. 2010;92(4):535–53993.

Den Hartog D Van Lieshout EMM Tuinebreijer WE Primary hemiarthroplasty versus conservative treatment for comminuted fractures of the proximal humerus in the elderly (ProCon): a multicenter randomized controlled trial. BMC Musculoskelet Disord. 2010;11:9794.

Martin TG Iannotti JP . Reverse total shoulder arthroplasty for acute fractures and failed management after proximal humeral fractures. Orthop Clin North Am. 2008;39(4):451–45795.

Slobogean GP Noonan VK O’Brien PJ . The reliability and validity of the Disabilities of Arm, Shoulder, and Hand, EuroQol-5D, Health Utilities Index, and Short Form-6D outcome instruments in patients with proximal humeral fractures. J Shoulder Elbow Surg. 2010;19(3):342–34896.

Centers for Disease Control and Prevention. Incidence and costs to Medicare of fractures among Medicare beneficiaries aged greater than or equal to 65 years—United States, July 1991-June 1992. MMWR Morb Mortal Wkly Rep. 1996;45(41):877–90097.

Brogren E Petranek M Atroshi I . Incidence and characteristics of distal radius fractures in a southern Swedish region. BMC Musculoskelet Disord. 2007;8:4898.

Kilgore ML Morrisey MA Becker DJ . Health care expenditures associated with skeletal fractures among Medicare beneficiaries, 1999-2005. J Bone Miner Res. 2009;24(12): 2050–205599.

Matullo KS Dennison DG . Lateral tilt wrist radiograph using the contralateral hand to position the wrist after volar plating of distal radius fractures. J Hand Surg Am. 2010;35(6):900–904.

Soong M Got C Katarincic J Akelman E . Fluoroscopic evaluation of intra-articular screw placement during locked volar plating of the distal radius: a cadaveric study. J Hand Surg Am. 2008;33(10):1720–1723.

Anzarut A Johnson JA Rowe BH Radiologic and patient-reported functional outcomes in an elderly cohort with conservatively treated distal radius fractures. J Hand Surg Am. 2004;29(6):1121–1127.

Fanuele J Koval KJ Lurie J Distal radial fracture treatment: what you get may depend on your age and address. J Bone Joint Surg Am. 2009;91(6):1313–1319.

Arora R Gabl M Gschwentner M A comparative study of clinical and radiologic outcomes of unstable Colles type distal radius fractures in patients older than 70 years: nonoperative treatment versus volar locking plating. J Orthop Trauma. 2009;23(4):237–242.

Marcheix PS Dotzis A Benko PE Extension fractures of the distal radius in patients older than 50: a prospective randomized study comparing fixation using mixed pins or a palmar fixed-angle plate. J Hand Surg Eur Vol. 2010;35(8): 646–651.

Schmelzer-Schmied N Wieloch P Martini AK Daecke W . Comparison of external fixation, locking and non-locking palmar plating for unstable distal radius fractures in the elderly. Int Orthop. 2009;33(3):773–778.

Figl M Weninger P Jurkowitsch J Unstable distal radius fractures in the elderly patient: volar fixed-angle plate osteosynthesis prevents secondary loss of reduction. J Trauma. 2010;68(4):992–998.

Rozental TD Blazar PE Franko OI Functional outcomes for unstable distal radial fractures treated with open reduction and internal fixation or closed reduction and percutaneous fixation: a prospective randomized trial. J Bone Joint Surg Am. 2009;91(8):1837–1846.

Kim DH Vaccaro AR . Osteoporotic compression fractures of the spine: current options and considerations for treatment. Spine J. 2006;6(5):479–487.

Compston J . Osteoporosis: social and economic impact. Radiol Clin North Am. 2010;48(3):477–482.

Ismail AA Cockerill W Cooper C Prevalent vertebral deformity predicts incident hip though not distal forearm fracture: results from the European Prospective Osteoporosis Study. Osteoporos Int. 2001;12(2):85–90.

Burge R Dawson-Hughes B Solomon DH Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007;22(3):465–475.

Wood KB Khanna G Vaccaro AR Assessment of two thoracolumbar fracture classification systems as used by multiple surgeons. J Bone Joint Surg Am. 2005;87(7):1423–1429.

Nguyen HV Ludwig S Gelb D . Osteoporotic vertebral burst fractures with neurologic compromise. J Spinal Disord Tech. 2003;16(1):10–19.

Nevitt MC Ettinger B Black DM The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med. 1998;128(10):793–800.

Karam M Lavelle WF Cheney R . The role of bone scintigraphy in treatment planning, and predicting pain relief after kyphoplasty. Nucl Med Commun. 2008;29(3):247–253.

Francis RM Aspray TJ Hide G Sutcliffe AM Wilkinson P . Back pain in osteoporotic vertebral fractures. Osteoporos Int. 2008;19(7):895–903.

Porter RW Hibbert C . Calcitonin treatment for neurogenic claudication. Spine (Phila Pa 1976). 1983;8(6):585–592.

Prather H Watson JO Gilula LA . Nonoperative management of osteoporotic vertebral compression fractures. Injury. 2007;38 (suppl 3):S40–S48.

Yan D Duan L Li J . Comparative study of percutaneous vertebroplasty and kyphoplasty in the treatment of osteoporotic vertebral compression fractures. Arch Orthop Trauma Surg. 2010 Sep 17. [Epub ahead of print].

Ledlie JT Renfro MB . Kyphoplasty treatment of vertebral fractures: 2-year outcomes show sustained benefits. Spine (Phila Pa 1976). 2006;31(1):57–64.

Shindle MK Gardner MJ Koob J Vertebral height restoration in osteoporotic compression fractures: kyphoplasty balloon tamp is superior to postural correction alone. Osteoporos Int. 2006;17(12):1815–1819.

Diamond TH Bryant C Browne L Clark WA . Clinical outcomes after acute osteoporotic vertebral fractures: a 2-year non-randomised trial comparing percutaneous vertebroplasty with conservative therapy. Med J Aust. 2006;184(3):113–117.

Barr JD Barr MS Lemley TJ McCann RM . Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine (Phila Pa 1976). 2000;25(8):923–928.

Hochmuth K Proschek D Schwarz W Percutaneous vertebroplasty in the therapy of osteoporotic vertebral compression fractures: a critical review. Eur Radiol. 2006;16(5): 998–1004.

Kasperk C Hillmeier J Noldge G Treatment of painful vertebral fractures by kyphoplasty in patients with primary osteoporosis: a prospective nonrandomized controlled study. J Bone Miner Res. 2005;20(4):604–612.

Buchbinder R Osborne RH Ebeling PR A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med. 2009;361(6):557–568.

Kallmes DF Comstock BA Heagerty PJ A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med. 2009;361(6):569–579.

Wardlaw D Cummings SR Van Meirhaeghe J Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet. 2009;373(9668):1016–1024.

Hiwatashi A Westesson PL . Vertebroplasty for osteoporotic fractures with spinal canal compromise. AJNR Am J Neuroradiol. 2007;28(4):690–692.

Salai M Dudkiewicz I Novikov I Amit Y Chechick A . The epidemic of ankle fractures in the elderly: is surgical treatment warranted? Arch Orthop Trauma Surg. 2000;120(9):511–513.

Bauer M Bengner U Johnell O Redlund-Johnell I Supination-eversion fractures of the ankle joint: changes in incidence over 30 years. Foot Ankle. 1987;8(1):26–28.

Kannus P Palvanen M Niemi S Parkkari J Jarvinen M. Increasing number and incidence of low-trauma ankle fractures in elderly people: Finnish statistics during 1970-2000 and projections for the future. Bone. 2002;31(3):430–433.

Hasselman CT Vogt MT Stone KL Cauley JA Conti SF . Foot and ankle fractures in elderly white women: incidence and risk factors. J Bone Joint Surg Am. 2003;85(5):820–824.

Holmberg AH Johnell O Nilsson PM Risk factors for fragility fracture in middle age: a prospective population-based study of 33,000 men and women. Osteoporos Int. 2006;17(7):1065–1077.

Seeley DG Kelsey J Jergas M Nevitt MC ; Study of Osteoporotic Fractures Research Group. Predictors of ankle and foot fractures in older women. J Bone Miner Res. 1996;11(9):1347–1355.

Adami S . Bone health in diabetes: considerations for clinical management. Curr Med Res Opin. 2009;25(5):1057–1072.

Schwartz AV Nevitt MC Brown BW Jr Kelsey JL . Increased falling as a risk factor for fracture among older women: the study of osteoporotic fractures. Am J Epidemiol. 2005;161(2):180–185.

Strauss EJ Egol KA . The management of ankle fractures in the elderly. Injury. 2007;38 (suppl 3):S2–S9.

Boden BP Osbahr DC . High-risk stress fractures: evaluation and treatment. J Am Acad Orthop Surg. 2000;8(6):344–353.

Robinson AH Pasapula C Brodsky JW . Surgical aspects of the diabetic foot. J Bone Joint Surg Br. 2009;91(1):1–7.

Schon LC Easley ME Weinfeld SB . Charcot neuroarthropathy of the foot and ankle. Clin Orthop Relat Res. 1998;349:116–131.

Lillmars SA Meister BR . Acute trauma to the diabetic foot and ankle. Curr Opin Orthop. 2001;12:100–105.

Wukich DK Kline AJ . The management of ankle fractures in patients with diabetes. J Bone Joint Surg Am. 2008;90(7):1570–1578.

Jones KB Maiers-Yelden KA Marsh JL Ankle fractures in patients with diabetes mellitus. J Bone Joint Surg Br. 2005;87(4):489–495.

Anglen JO Burd TA Hendricks KJ Harrison P . The “gull sign”: a harbinger of failure for internal fixation of geriatric acetabular fractures. J Orthop Trauma. 2003;17(9):625–634.

Krappinger D Kammerlander C Hak DJ Blauth M . Low-energy osteoporotic pelvic fractures. Arch Orthop Trauma Surg. 2010;130(9):1167–1175.

Mears DC Velyvis JH . In situ fixation of pelvic nonunions following pathologic and insufficiency fractures. J Bone Joint Surg Am. 2002;84(5):721–728.

Ferguson TA Patel R Bhandari M Matta JM . Fractures of the acetabulum in patients aged 60 years and older: an epidemiological and radiological study. J Bone Joint Surg Br. 2010;92(2):250–257.

Gary JL Lefaivre KA Gerold F . Survivorship of the native hip joint after percutaneous repair of acetabular fractures in the elderly. Injury. 2010 Sep 16. [Epub ahead of print].

Mears DC Velyvis JH . Acute total hip arthroplasty for selected displaced acetabular fractures: two to twelve-year results. J Bone Joint Surg Am. 2002;84(1):1–9.

1Mokhtari-Dizaji M Sharafi AA Larijani B Mokhlesian N Hasanzadeh H . Estimating the absorbed dose to critical organs during dual X-ray absorptiometry. Korean J Radiol. 2008;9(2):102–110.

World Health Organization. Prevention and management of osteoporosis: report of a WHO scientific group. World Health OrganTech Rep Ser. 2003;921:1–164.

Unnanuntana A Gladnick BP Donnelly E Lane JM . The assessment of fracture risk. J Bone Joint Surg Am. 2010;92(3):743–753.

Cummings SR Melton LJ . Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002;359(9319):1761–1767.

Kanis JA Johnell O . The burden of osteoporosis. J Endocrinol Invest. 1999;22(8):583–588.

National Osteoporosis Foundation. Clinician’s Guide to Prevention and Treatment of Osteoporosis. http://www.nof.org/professionals/NOF_Clinicians_Guide.htm. Accessed September 3, 2009.

Painter SE Kleerekoper M Camacho PM . Secondary osteoporosis: a review of the recent evidence. Endocr Pract. 2006;12(4):436–445.

Oyen J Gjesdal CG Brudvik C Low-energy distal radius fractures in middle-aged and elderly men and women—the burden of osteoporosis and fracture risk: a study of 1794 consecutive patients. Osteoporos Int. 2010;21(7):1257–1267.

Holick MF . Vitamin D deficiency. N Engl J Med. 2007;357(3):266–281.

Deutschmann HA Weger M Weger W Search for occult secondary osteoporosis: impact of identified possible risk factors on bone mineral density. J Intern Med. 2002;252(5):389–397.

Wicherts IS van Schoor NM Boeke AJP Vitamin D status predicts physical performance and its decline in older persons. J Clin Endocrinol Metab. 2007;92(6):2058–2065.

Holick MF . Vitamin D: extraskeletal health. Endocrinol Metab Clin North Am. 2010;39(2):381–400.

Vieth R . Vitamin D toxicity, policy, and science. J Bone Miner Res. 2007;22 (suppl 2):V64–V68.

Black DM Thompson DE Bauer DC Fracture risk reduction with alendronate in women with osteoporosis: the Fracture Intervention Trial. J Clin Endocrinol Metab. 2000;85(11):4118–4124.

Harris ST Watts NB Genant HK Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. JAMA. 1999;282(14):1344–1352.

Neer RM Arnaud CD Zanchetta JR Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001;344(19):1434–1441.

Russell RGG Watts NB Ebetino FH Rogers MJ . Mechanisms of action of bisphosphonates: similarities and differences and their potential influence on clinical efficacy. Osteoporos Int. 2008;19(6):733–759.

Lyles KW Colon-Emeric CS Magaziner JS Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med. 2007;357(18):1799–1809.

Rossouw JE Anderson GL Prentice RL Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002;288(3):321–333.

Anderson GL Limacher M Assaf AR Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. JAMA. 2004;291(14):1701–1712.

Ettinger B Black DM Mitlak BH Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. JAMA. 1999;282(7):637–645.

Lippman ME Cummings SR Disch DP Effect of raloxifene on the incidence of invasive breast cancer in postmenopausal women with osteoporosis categorized by breast cancer risk. Clin Cancer Res. 2006;12(17):5242–5247.

Cummings SR San Martin J McClung MR Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009;361(8):756–765.

Standing Committee on the Scientific Evaluation of Dietary Reference Intakes/Food Nutrition Board/Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academies Press; 1997.

Kothawala P Badamgarav E Ryu S Miller RM Halbert RJ . Systematic review and meta-analysis of real-world adherence to drug therapy for osteoporosis. Mayo Clin Proc. 2007;82(12):1493–1501.

Siris ES Harris ST Rosen CJ Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc. 2006;81(8):1013–1022.

Tinetti ME . Clinical practice: preventing falls in elderly persons. N Engl J Med. 2003;348(1):42–49.

Sattin RW Lambert Huber DA DeVito CA The incidence of fall injury events among the elderly in a defined population. Am J Epidemiol. 1990;131(6):1028–1037.

Miniño AM Arias E Kochanek KD Murphy S Smith BL . Deaths: final data for 2000. Natl Vital Stat Rep. 2002;50(15):1–120.

Gillespie LD Robertson MC Gillespie WJ . Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2009;(2):CD007146.

King MB Tinetti ME . A multifactorial approach to reducing injurious falls. Clin Geriatr Med. 1996;12(4):745–759.

American Geriatrics Society, British Geriatrics Society, American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001;49(5):664–672.

Teno J Kiel DP Mor V . Multiple stumbles: a risk factor for falls in community-dwelling elderly. A prospective study. J Am Geriatr Soc. 1990;38(12):1321–1325.

Greenspan SL Myers ER Kiel DP Fall direction, bone mineral density, and function: risk factors for hip fracture in frail nursing home elderly. Am J Med. 1998;104(6):539–545.

Woolcott JC Richardson KJ Wiens MO Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med. 2009;169(21):1952–1960.

Myers AH Baker SP Van Natta ML Abbey H Robinson EG . Risk factors associated with falls and injuries among elderly institutionalized persons. Am J Epidemiol. 1991;133(11):1179–1190.

Stevens JA Sogolow ED , eds. Preventing Falls: What Works. A CDC Compendium of Effective Community-Based Interventions From Around the World. Atlanta, GA: National Center for Injury Prevention and Control; 2008.

Lord SR Dayhew J Howland A . Multifocal glasses impair edge-contrast sensitivity and depth perception and increase the risk of falls in older people. J Am Geriatr Soc. 2002;50(11):1760–1766.

Mukai S Lipsitz LA . Orthostatic hypotension. Clin Geriatr Med. 2002;18(2):253–268.

Kenny RAM Richardson DA Steen N Carotid sinus syndrome: a modifiable risk factor for nonaccidental falls in older adults (SAFE PACE). J Am Coll Cardiol. 2001;38(5):1491–1496.

Tinetti ME Speechley M Ginter SF . Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319(26):1701–1707.

Koepsell TD Wolf ME Buchner DM Footwear style and risk of falls in older adults. J Am Geriatr Soc. 2004;52(9):1495–1501.

Cumming RG Thomas M Szonyi G Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention. J Am Geriatr Soc. 1999;47(12):1397–1402.

Stevens M Holman CDJ Bennett N . Preventing falls in older people: impact of an intervention to reduce environmental hazards in the home. J Am Geriatr Soc. 2001;49(11):1442–1447.

Nakamura T Meguro K Sasaki H . Relationship between falls and stride length variability in senile dementia of the Alzheimer type. Gerontology. 1996;42(2):108–113.

Allan LM Ballard CG Rowan EN Kenny RA . Incidence and prediction of falls in dementia: a prospective study in older people. PLoS One. 2009;4(5):e5521.

Arora VM Prochaska ML Farnan JM Problems after discharge and understanding of communication with their primary care physicians among hospitalized seniors: a mixed methods study. J Hosp Med. 2010;5(7):385–391.

Kohn LT Corrigan JM Donaldson MS , eds. To Err Is Human: Building a Safer Health System . Washington, DC: National Academies Press; 2000.

Reuben DB Herr KA Pacala JT Geriatrics at Your Fingertips. New York: American Geriatrics Society; 2006.

Dell RM Greene D Anderson D Williams K . Osteoporosis disease management: what every orthopaedic surgeon should know. J Bone Joint Surg Am. 2009;91 (suppl 6):79–86.