Schnitzer T J, Wehren L E
Department of Medicine, Northwestern University, Chicago, IL, USA.
QJM. 2004 Feb;97(2):101-4. doi: 10.1093/qjmed/hch019.
Osteoporosis can now be diagnosed readily, and treatments that increase bone mineral density and decrease fracture risk, even after fragility fracture has occurred, are now available. Clinical guidelines for management of osteoporosis unanimously recognize that fracture risk is highest among those who have already sustained a fracture, and encourage prompt evaluation and treatment of these individuals. Despite these guidelines, most women who experience fragility fractures remain untreated (for osteoporosis) by any of the physicians involved in their care. Barriers to diagnosis and treatment have been identified, including uncertainty about the responsibility for such management. The orthopaedic surgeon has a unique opportunity to initiate definitive osteoporosis evaluation and treatment in patients who present with fractures, and recent guidelines support the evolution of the role of the orthopaedist in this direction.
骨质疏松症现在可以很容易地被诊断出来，而且即使在发生脆性骨折后，目前也有能够增加骨矿物质密度并降低骨折风险的治疗方法。骨质疏松症管理的临床指南一致认为，骨折风险在那些已经发生过骨折的人群中最高，并鼓励对这些个体进行及时评估和治疗。尽管有这些指南，但大多数经历脆性骨折的女性在其接受治疗的任何医生处（针对骨质疏松症）仍未得到治疗。已经确定了诊断和治疗的障碍，包括对此类管理责任的不确定性。骨科医生有独特的机会对骨折患者启动确定性的骨质疏松症评估和治疗，并且最近的指南支持骨科医生在这个方向上角色的转变。
