Management of Fractures in Severely Osteoporotic Bone: Orthopedic and Pharmacologic Strategies

Over the past decade, major advances have taken place in the management of osteoporosis. Newdasses of pharmaceutical agents have been developed, tested, and used to treat millions of patients; education and early detection programs have been instituted around the world; and bone densitometry has received widespread recognition by healthcare agencies as being central to the preven­ tive health strategy necessary to care for an aging population. With all these advances, scientists continue to explore new methods to understand and treat this disease. The field of orthopaedic surgery has a great opportunity to bring this new information to its dinics and operating rooms. It is critically impor­ tant that the practicing surgeon be armed with this knowledge. Fractures are dearly the most common orthopaedic problem associated with osteoporosis. The goals of treatment are rapid restoration of mobilityand func­ tion and return of patients to a level of activity that supports their general health. The ability to control the metabolic condition or to treat the under­ lying cause of the osteoporosis with pharmacological intervention willimprove surgical results. Moreover, the special techniques required to succeed in the operative treatment of bone, which is already weakened by osteoporosis, must be carefully developed, tested, and understood. This book provides the first attempt to bring this body of information to the orthopaedic surgeon in a dearly organized and comprehensive way. Historically, few orthopaedic surgery or trauma training programs have offered much in the way of education in the science of bone metabolism.