INTERNAL FIXATION IN OSTEOPOROTIC

Abstract

Osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to increased bone fragility and fracture risk. The new WHO consensus definition reflects the importance of bone mass measurement in the diagnosis of osteoporosis and implies that the occurrence of fractures is not essential to the diagnosis. Osteoporosis can be classified as primary or secondary, depending on the absence or presence of an associated medical condition known to cause bone loss. Secondary causes of osteoporosis can be identified in 20% of women and 40% of men presenting with vertebral fractures and should always be sought.

Identifying patients at risk of developing osteoporosis is important in order to determine those who will benefit from the different therapeutic interventions. Methods to identify such patients include a thorough medical history to pinpoint possible risk factors, imaging bone densitometry, laboratory studies, and bone histomorphometry.

Bone fracture, especially fracture with minimal trauma, is the feared endpoint of osteoporosis. Fractures of the wrist, hip, and vertebrae are well recognized consequences of the loss of mechanical strength that occurs as bone thins. These fractures are common in many countries, particularly among elderly people, and the burden they produce is expected to rise enormously in the next few decades. The. mortality rate in an elderly person with hip fracture e.g. approaches 20% and those who survive mobility remains permanently impaired in over half of the patients.