Closing the Osteoporosis Care Gap in Hip Fracture Patients: An Opportunity to Decrease Recurrent Fractures and Hospital Admissions

Table 2

Top ten suggested recommendations for all hip fracture patients over age 65.

(1) Supplement to total (dietary and prescribed) elemental calcium 1200 mg daily (as average daily dietary calcium intake is around 600 mg, supplement with extra 600 mg, unless high dietary intake history)
(2) Supplement with vitamin D 800–2000 I.U. daily
(3) Consider first-line treatment with bisphosphonate-alendronate, risedronate, or i.v. zoledronic acid
(4) No need for DXA scan to initiate treatment, consider baseline DXA scan to assess bone density to follow response to treatment
(5) Assess and minimize fall risk and review all contributing risk factors
(6) Hip protectors if compliance can be ascertained (supervision, long term care setting)
(7) Patient and family education on osteoporosis, risk factors, importance of treatment to assure patient understanding, and improved compliance
(8) Encourage exercise—Tai Chi for balance and weight bearing if possible
(9) Develop specialized follow-up fracture clinics and orthogeriatric collaboration services for older hip fracture adults
(10) Followup DXA scan at the same location to asses bone density 1–3 years after the initiation of treatment to ensure compliance and response