• Anne-Maree Kelly, Megan Clooney, Debra Kerr, and Peter R Ebeling.
• Joseph Epstein Centre for Emergency Medicine Research, Western Health, Melbourne, VIC. Anne-Maree.Kelly@wh.org.au
• Med. J. Aust. 2008 Apr 7;188(7):389-91.

ObjectiveMinimal trauma fractures may be the first indication of osteoporosis. Our aim was to determine the proportion of patients who underwent bone density testing for osteoporosis of those with a minimal trauma wrist fracture treated in the emergency department (ED).DesignThis observational retrospective cohort study used explicit medical record review and scripted telephone interviews.SettingEDs of three metropolitan hospitals in Melbourne in 2006.ParticipantsPatients aged 50 years and over who were treated for wrist fracture due to minimal trauma. Data collected included demographic details, fracture details, causes of injury, any bone density testing and any osteoporosis-related medication change.Main Outcome MeasureThe proportion of patients who underwent bone density testing in the follow-up period.Results131 patients were studied; 83% were female, and the median age was 71 years. No patient was referred by an ED or fracture clinic for bone density testing (95% CI, 0-3.5%). Telephone follow-up data were obtained from 91 patients. Of these, 28 reported having bone density testing after their fracture, of whom 14 (50%; 95% CI, 32%-67%) were found to have osteoporosis. Seven were treated with a bisphosphonate and one with a selective oestrogen-receptor modulator.ConclusionFollow-up of patients suffering minimal trauma wrist fractures treated in the ED is poor. Systems to improve the identification and treatment of osteoporosis in this group are needed if future osteoporotic fractures and their consequences are to be avoided.

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