Dr Abraham seems to imply that orthopedists may be culpable for the undertreatment of osteoporosis in patients with fracture. Patients with atraumatic fractures often have low bone mineral density1 and are at heightened risk for additional fractures.2 Orthopedists recognize that there is a window of opportunity to educate patients with fracture about osteoporosis and perhaps even initiate treatment.3 However, fracture repair is the immediate concern of the orthopedist. Patients often do not return to see their orthopedist after the fracture is healed; thus, it may be inappropriate for the orthopedist to initiate long-term treatment.
Kiebzak GM, Beinart GA, Perser K, Ambrose CG, Siff SJ, Heggeness MH. Undertreatment of Osteoporosis in Men Who Have Had a Hip Fracture—Reply. Arch Intern Med. 2003;163(10):1236-1237. doi:10.1001/archinte.163.10.1236-a