Archives of Osteoporosis最新文献

{"title":"Global perspectives on the burden and management of hypophosphataemic osteomalacia in adult patients: an International Osteoporosis Foundation (IOF) survey","authors":"Maria Luisa Brandi,&nbsp;Philippe Halbout,&nbsp;Dominique D. Pierroz,&nbsp;Nicholas C. Harvey","doi":"10.1007/s11657-026-01692-y","DOIUrl":"10.1007/s11657-026-01692-y","url":null,"abstract":"<div><h3>Summary</h3><p>This survey collected global perspectives on the burden and management of hypophosphataemic osteomalacia in adults through the International Osteoporosis Foundation (IOF). The IOF network represents a valuable international resource for understanding the burden and management of rare bone disorders.</p><h3>Purpose</h3><p>To investigate the international burden and management of hypophosphataemic osteomalacia (HO) in adult patients.</p><h3>Methods</h3><p>A survey was developed consisting of seven questions about respondents and their experiences of managing HO, with a second section inviting additional non-identifying information on up to five patients. The survey was disseminated to the International Osteoporosis Foundation (IOF) network.</p><h3>Results</h3><p>Forty clinicians from 24 countries responded, with most based in academic centres. Respondents reported managing over 1000 adult patients with HO, primarily diagnosed with X-linked hypophosphataemia (XLH; 35%), tumour-induced osteomalacia (TIO; 24%), and fibrous dysplasia/McCune–Albright syndrome (FD/MAS; 16%). Management varied by diagnosis, reflecting differences in the underlying pathophysiology and clinical manifestations of the disorders. Respondents provided additional information on 19 patients with XLH, 28 with TIO, and 9 with other HO disorders. Common symptoms across XLH and TIO included bone pain (XLH, 67%; TIO, 88%), muscle pain (XLH, 61%; TIO, 76%), and muscle weakness (XLH, 61%; TIO, 88%). Many patients with XLH had discontinued phosphate and vitamin D therapies, with a subset initiating burosumab treatment. In contrast, phosphate and vitamin D were commonly used in TIO, with many patients being considered for tumour resection and limited burosumab use. Pain medication use, including opiates, was relatively high across all patients.</p><h3>Conclusion</h3><p>Adults with HO experience a significant burden of musculoskeletal symptoms. Future efforts should focus on global education of healthcare professionals. The IOF network represents a valuable international resource for understanding the burden and management of rare bone disorders.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignant transformation in patients with monoclonal gammopathy of undetermined significance treated with teriparatide for osteoporosis: a bicenter retrospective study and analysis of the French national pharmacovigilance database","authors":"R. Cassez,&nbsp;B. Cortet,&nbsp;B. Bouvard,&nbsp;D. Theis,&nbsp;C. Potey,&nbsp;S. Manier,&nbsp;J. Paccou,&nbsp;C. Philippoteaux","doi":"10.1007/s11657-026-01693-x","DOIUrl":"10.1007/s11657-026-01693-x","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Malignant transformation in patients with monoclonal gammopathy of undetermined significance treated with teriparatide was evaluated. Among 29 patients, only two progressed to hematologic malignancy (one multiple myeloma, one Waldenström’s macroglobulinemia). These findings are reassuring and suggest that TPT may remain an option for selected patients with severe osteoporosis and MGUS.</p><h3>Purpose</h3><p>Osteoporosis is a highly prevalent bone disease with limited therapeutic options, particularly in multimorbid patients. Monoclonal gammopathy of undetermined significance (MGUS), a frequent finding in osteoporosis and a recognized fracture risk factor, often leads to contraindication of teriparatide (TPT), further restricting treatment choices. This study aimed to assess hematologic malignant transformation in osteoporotic patients with MGUS treated with TPT.</p><h3>Methods</h3><p>A retrospective bicenter observational study was conducted at Lille and Angers University Hospitals (2016–2022). Patients with osteoporosis and confirmed MGUS at TPT initiation were included. Demographic, hematologic, bone, and treatment parameters were collected. In parallel, hematologic malignancies reported with TPT were reviewed from the French national pharmacovigilance database (PVDB) over the same period.</p><h3>Results</h3><p>Twenty-nine patients (69% women; mean age 72.6 ± 12.6 years) were included. Most had major comorbidities (89.7% with Charlson Comorbidity Index ≥ 3). MGUS was IgG-type in 55.2% and IgM-type in 41.4%. The mean follow-up from TPT initiation was 60.2 ± 30.7 months (median 54.0; 95% CI 49.0–71.4). Two patients developed hematologic malignancy: one multiple myeloma (MM) 7 years after TPT and one Waldenström’s macroglobulinemia 21 months after initiation, both with intermediate-risk MGUS. TPT was well tolerated with premature discontinuation in 17.2% of cases. Of the two hematologic malignancies identified in the PVDB, only one (MM) occurred in a patient with pre-existing MGUS.</p><h3>Conclusion</h3><p>Malignant progression was rare, providing reassuring evidence regarding hematologic safety. TPT may be considered in selected patients with severe osteoporosis and MGUS, provided careful hematologic monitoring.</p><h3>Graphical abstract</h3>\u0000<div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracture liaison services: successful implementation in Belgium using a regional healthcare quality improvement initiative","authors":"Michaël R. Laurent,&nbsp;Pieter Samaey,&nbsp;M. Kassim Javaid","doi":"10.1007/s11657-026-01696-8","DOIUrl":"10.1007/s11657-026-01696-8","url":null,"abstract":"<div><h3>Introduction</h3><p>Fracture liaison services (FLS) are an evidence-based method to improve the diagnosis and treatment of osteoporosis in post-fracture patients and the quality of secondary fracture prevention. The Capture the Fracture® initiative provides a systematic framework for the development, implementation, continued improvement, and recognition of FLS internationally. This short communication is aimed at describing the progress and successful elements of FLS implementation in Belgium.</p><h3>Methods</h3><p>Descriptive report of a healthcare quality improvement initiative in accordance with SQUIRE 2.0 reporting standards.</p><h3>Results</h3><p>The first FLS Academy and Network (FAN) meeting in Belgium was held in 2023. Further regional working group activities resulted in rapid expansion from 5 to 20 recognized FLS centres in the country over 2.5 years, almost exclusively situated in the provinces where field support activities were focused.</p><h3>Conclusion</h3><p>A regional approach involving multiple stakeholders in partnership with industry can successfully facilitate implementation of national guidelines and close the care gap post-fracture in osteoporosis, even in the absence of governmental support.</p><h3>\u0000 <i>Summary</i>\u0000 </h3><p>We report the successful implementation of fracture liaison services in Belgian hospitals in two provinces using a regional action plan involving a clinical-industry collaboration, despite the absence of government financial incentives. Insights from this healthcare quality improvement initiative could serve as a blueprint to further close the osteoporosis care gap.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors in elderly female patients for refracture within two years following surgery for fragility fractures: a prospective observational study","authors":"Lili Wang,&nbsp;Baohua Chen,&nbsp;Cuicui Xin,&nbsp;Ying Guo,&nbsp;Yuzhi Song,&nbsp;Huihui Wang","doi":"10.1007/s11657-026-01689-7","DOIUrl":"10.1007/s11657-026-01689-7","url":null,"abstract":"<p>This prospective study of 784 elderly women found that age, high fall risk, and frailty increase refracture risk after fragility fracture surgery, whereas family support, hemoglobin, and albumin levels are protective, highlighting the need for comprehensive geriatric assessment.</p><p>The incidence of fragility fractures is high among elderly women, and the risk of secondary fractures significantly increases after the first fracture, leading to higher mortality rates, complications, and socioeconomic burdens. Identifying risk factors for refracture is crucial for prevention. However, there is currently limited analysis of risk factors for postoperative refracture in elderly women in China.</p><p>The objectives of this study were to investigate the incidence of recurrent fractures within 2 years after surgery for fragility fractures in elderly women and to identify associated risk factors.</p><p>This prospective observational study enrolled 784 elderly female patients undergoing surgery for fragility fractures at three hospitals in Shandong Province, China, between January and December 2022. Data of a total of 33 variables were collected, including demographic characteristics, comorbidities, laboratory indicators, fall risk, frailty status, family support, and medication use. Univariate analysis and binary logistic regression were used to identify factors associated with refracture within 2 years post-surgery.</p><p>A total of 53 patients (6.76%) experienced refracture within 2 years post-surgery. Multivariate analysis revealed that advanced age (OR = 1.103), high fall risk (OR = 7.907), and frailty (OR = 1.482) were independent risk factors for postoperative refracture. Conversely, living with family (OR = 0.416), higher hemoglobin levels (OR = 0.975), higher serum albumin levels (OR = 0.895), and stronger family support (OR = 0.891) were protective factors against refracture.</p><p>Preventing postoperative refracture in elderly women with fragility fractures requires a systematic approach. Clinical practice should incorporate comprehensive geriatric assessments, routinely including fall risk evaluation, frailty screening, and nutritional status assessment, while emphasizing and leveraging family support systems. It is recommended to integrate fall prevention education, frailty intervention, nutritional support, and family involvement into standard fracture liaison services, forming multidimensional, individualized management strategies to effectively reduce refracture risk.</p>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147571993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of bone mineral density testing in the national health screening program on osteoporosis-related medical visits and fractures among women","authors":"Jae Hyeok Lim,&nbsp;Jiyeon Chun,&nbsp;Gyung-Joo Min,&nbsp;Dan Bi Kim,&nbsp;Jisu Ko,&nbsp;Eun-Cheol Park","doi":"10.1007/s11657-026-01673-1","DOIUrl":"10.1007/s11657-026-01673-1","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Evaluation of the effectiveness of bone mineral density (BMD) testing within national health screening programs should consider country-specific contexts when applied to asymptomatic populations. BMD testing at age 66 in women was associated with increased osteoporosis-related medical visit and a reduction of subsequent fracture incidence. These findings suggest potential benefits of population-based screening with BMD testing.</p><h3>Purpose</h3><p>Early detection of osteoporosis through bone mineral density (BMD) testing may help prevent future fractures. This study aimed to investigate the impact of incorporating BMD testing in South Korea’s national health screening program on outpatient visits with an osteoporosis diagnosis and fractures.</p><h3>Methods</h3><p>We used data from the Korean National Health Insurance Service–Senior Cohort (2002–2019) and included only women aged 66 years, as specified by national screening policy, without prior osteoporosis who underwent national health screening between 2004 and 2009. Screening periods were categorized by the inclusion of BMD testing. Outcomes included osteoporosis-related medical visits within two years and incident osteoporotic fractures. Multivariable logistic regression and Cox proportional hazards regression were used to examine osteoporosis detection and fracture risk, respectively.</p><h3>Results</h3><p>Among the 24,895 women screened, 24.7% had osteoporosis-related medical visits within two years, and 21.5% experienced fractures during follow-up. Compared to the period without BMD testing, the inclusion of BMD testing was associated with a 52% increase in osteoporosis-related medical visits (odds ratio: 1.52, 95% confidence interval [CI]: 1.42–1.62), whereas the risk of subsequent fractures was reduced by 9% (hazard ratio: 0.91, 95% CI: 0.86–0.96). These associations were more pronounced among those with low body mass index and significant during the 5–10 years of follow-up for hip and vertebral fractures.</p><h3>Conclusion</h3><p>Nationwide implementation of BMD testing increased the medical visits for osteoporosis and was associated with a reduction in subsequent fractures. To further enhance the effectiveness of the screening program, improved post-screening management is needed.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13018048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digitally enhanced fracture liaison service in Austria—a feasibility analysis","authors":"Aaron Pfender,&nbsp;Martina Behanova,&nbsp;Judith Haschka,&nbsp;Johannes Holinka,&nbsp;Daniela Kritsch,&nbsp;Daniel Mattes,&nbsp;Julia Kaufmann,&nbsp;Jochen Zwerina,&nbsp;Roland Kocijan","doi":"10.1007/s11657-026-01691-z","DOIUrl":"10.1007/s11657-026-01691-z","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Fragility fractures often signal untreated osteoporosis. This study shows that a digitally enhanced Fracture Liaison Service (FLS) can identify affected patients in routine hospital care and improve structured assessment and treatment. Dedicated staff remain essential to translate digital solutions into effective fracture prevention.</p><h3>Purpose</h3><p>Although Fracture Liaison Services (FLS) are established internationally, structured programs remain scarce in Austria. This study aimed to assess the real-world feasibility of a digitally supported, International Osteoporosis Foundation (IOF)–certified FLS implemented in routine inpatient care.</p><h3>Methods</h3><p>We conducted a retrospective, monocentric cohort study at a tertiary care hospital in Vienna, Austria. Hospitalized patients aged ≥ 50 years with major osteoporotic fractures were included in a digital FLS module integrated into the hospital information system between April 2023 and March 2024. Feasibility parameters included patient capture rate, implementation of standardized diagnostics, and initiation or recommendation of osteoporosis therapy.</p><h3>Results</h3><p>Overall, 141 patients were enrolled (78% women; mean age 75.8 ± 11.4 years). Vertebral (31.9%) and hip fractures (25.5%) were the most frequent fracture sites. A previous fragility fracture was documented in 46.1% of patients; 24.1% had a prior diagnosis of osteoporosis. In total, 38.1% of all eligible inpatients with osteoporotic fractures were included in the digital FLS. Calcium and vitamin D supplementation was initiated during hospitalization in 73.0% of patients. Specific antiosteoporotic medication was initiated during the inpatient stay in 15.6% and in the outpatient setting in 9.9% and 8.5% of patients, respectively. Treatment was recommended for post-discharge initiation in 56.0% of cases. The most commonly prescribed drugs were denosumab and zoledronic acid.</p><h3>Conclusion</h3><p>Implementation of a digitally integrated FLS in routine inpatient care is feasible and enables structured identification, assessment, and treatment recommendation for patients with fragility fractures. However, limited staffing resources and challenges in post-discharge therapy implementation highlight the need for dedicated personnel and improved cross-sectoral care pathways.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13013220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporosis treatment indications following fracture: identifying relevant fracture sites for Fracture Liaison Services","authors":"Mattias Lorentzon,&nbsp;Christine Florberger,&nbsp;Javier Merina,&nbsp;Eric Bertholds,&nbsp;Henrik Litsne,&nbsp;Kristian F. Axelsson","doi":"10.1007/s11657-026-01690-0","DOIUrl":"10.1007/s11657-026-01690-0","url":null,"abstract":"","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between physical function parameters and fracture risk in older women in primary health care in southern Brazil","authors":"Léo Canterle Dal Osto,&nbsp;Luana Fioravanti Roland,&nbsp;Mariá Nunes Pinto,&nbsp;Vitor Pelegrim de Oliveira,&nbsp;Kawoana Trautman Vianna,&nbsp;Renato Gorga Bandeira de Mello,&nbsp;Poli Mara Spritzer,&nbsp;Tayane Muniz Fighera","doi":"10.1007/s11657-026-01688-8","DOIUrl":"10.1007/s11657-026-01688-8","url":null,"abstract":"<div><h3>Summary</h3><p>Simple functional measures may help identify older women at high fracture risk. In this cross-sectional study, reduced handgrip strength, calf circumference, and lean mass were associated with higher risk of fracture by FRAX. These easily obtainable parameters may enhance fracture-risk screening in primary care.</p><h3>Purpose</h3><p>To examine the associations between frailty, sarcopenia-related parameters, and fracture risk in community-dwelling older women, and to evaluate whether simple functional measures may help identify individuals at elevated risk of osteoporotic fractures.</p><h3>Methods</h3><p>We conducted a cross-sectional study including women aged ≥ 60 years recruited from a primary care facility in Southern Brazil. Frailty was assessed using the Clinical Frailty Scale, and muscle strength and physical performance were evaluated using SARC-F, Timed Up and Go, gait speed, the Short Physical Performance Battery, calf circumference (CC), and handgrip strength (HGS). Bone mineral density and trabecular bone score (TBS) were measured by DXA. Ten-year fracture probability was estimated using the Brazilian FRAX® algorithm. Appendicular lean mass index (ALMI) and biochemical markers relevant to bone metabolism were also analyzed.</p><h3>Results</h3><p>Among the 119 participants, 38.5% were classified as having high or very high 10-year fracture risk. Compared with women in the low-risk group, those at high risk were older and had lower BMI, TBS, HGS, CC, and ALMI, in addition to a higher comorbidity burden. In multivariable Poisson regression adjusted for age and comorbidity, lower muscle strength, reduced muscle mass, and poorer physical performance were independently associated with higher fracture risk prevalence, whereas frailty status was not. Among the muscle parameters, ALMI showed the strongest association with high fracture risk.</p><h3>Conclusion</h3><p>Reduced muscle strength and lean mass were associated with higher fracture risk, even in women without established frailty or sarcopenia. HGS and CC emerge as simple, low-cost indicators that may enhance fracture-risk screening in primary care and complement conventional assessments such as DXA and FRAX.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced walking speed at discharge predicts mortality after clinical osteoporotic vertebral fracture: A retrospective cohort study","authors":"Hiroyuki Tominaga,&nbsp;Shinobu Uezono,&nbsp;Ichiro Kawamura,&nbsp;Yoshitaka Yamashita,&nbsp;Noboru Taniguchi","doi":"10.1007/s11657-026-01686-w","DOIUrl":"10.1007/s11657-026-01686-w","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>This study investigated how walking speed affects survival in patients with clinical osteoporotic vertebral fractures. A walking speed below 0.71 m/sec was associated with increased mortality. Walking speed may serve as a simple yet powerful prognostic indicator, highlighting the importance of mobility preservation in fracture management.</p><h3>Purpose</h3><p>The number of patients with fractures caused by osteoporosis has increased with the increasing proportion of aging adults in recent years. Osteoporotic vertebral fractures (OVFs) are associated with poor prognosis. Although several reports on the life expectancy of patients with OVFs exist, it is unclear how walking speed affects the life expectancy of patients with clinical OVFs. This study investigated the relationship between walking speed and life expectancy after injury in patients with clinical OVFs.</p><h3>Methods</h3><p>A total of 104 patients with new clinical OVFs were conservatively treated with a trunk cast from 2015 to 2017. Lumbar spine and femur bone mineral density (BMD), the Geriatric Nutritional Risk Index (GNRI), walking speed, and spinopelvic parameters were measured. We compared the deceased and survival groups and examined the risk factors influencing survival.</p><h3>Results</h3><p>Among the 104 patients included in the study, 67 were women; the median age was 82 years, and the median observation period was 1168 days. Thirty-two patients died during the observation period. The deceased group had a lower GNRI and a slower walking speed at discharge. In addition, imaging revealed more local kyphosis and more calcification of vessels in the deceased group. The risk of death increased when the walking speed after the OVF was less than 0.71 m/sec.</p><h3>Conclusion</h3><p>A walking speed of 0.71 m/sec or slower was associated with poor prognosis after clinical vertebral fracture. Nutritional management, kyphotic deformity prevention, and walking speed maintenance are essential for vertebral fracture treatment.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of osteoporosis pharmacotherapy and vitamin d supplementation on fracture morphology and treatment of pelvic fragility fractures: a retrospective cohort study of 1493 patients from the German Pelvic Trauma Registry","authors":"Alexander Trulson,&nbsp;Stefan Huber,&nbsp;Eftychios Bolierakis,&nbsp;Till Berk,&nbsp;Fabian Stuby,&nbsp;Andreas Höch,&nbsp;Christian Kleber,&nbsp;Isabel Graul,&nbsp;Philipp Pieroh","doi":"10.1007/s11657-026-01687-9","DOIUrl":"10.1007/s11657-026-01687-9","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Osteoporosis causes bone fragility and fractures, yet most patients receive no treatment. This German registry study of nearly 1500 elderly pelvic fracture patients found that two-thirds were untreated before fracture. Paradoxically, treated patients sustained more severe, displaced fractures requiring surgery more often, possibly reflecting advanced disease severity or altered bone properties from medication.</p><h3>Background</h3><p>Fragility fractures of the pelvis (FFP) are related to low-energy trauma and osteoporosis. Currently, data on secondary pharmacological fracture prevention and their effect on fracture morphology is rare. We aimed to determine the proportion of patients receiving specific osteoporosis medication (SOM), vitamin D supplementation only (VitD), or no treatment (NOT) before and after a FFP. Secondarily, we evaluated possible differences in fracture morphology and treatment in the study population.</p><h3>Methods</h3><p>This retrospective cohort study analyzed data from the German Pelvic Fracture Registry (2018–2024) of patients ≥ 60 years with an FFP. Patients were grouped hierarchically in the following groups: SOM, VitD, or NOT. Demographics, fracture morphology, treatment, and postfracture group changes regarding osteoporosis treatment were compared between groups.</p><h3>Results</h3><p>Of 1493 patients, mean age 82.34 ± 8.06 years, predominantly female (83.5%), 98 (6.6%) had a SOM, 386 (25.9%) VitD, and 1009 (67.6%) NOT before FFP. The SOM group was significantly older, predominantly female (<i>p</i> &lt; 0.05), and demonstrated higher prefracture functional independence (71.4% SOM vs. 58.5% VitD vs. 66.4% NOT; <i>p</i> = 0.018). FFP Type IV fractures occurred more frequently in the SOM group (33.7% SOM vs. 23.3% VitD, 19.8% NOT; <i>p</i> = 0.006) and were more frequently operatively treated (45.9% SOM vs. 30.4% VitD, 29.2% NOT; <i>p</i> = 0.006). Following a FFP, in 527 patients (35.9%), the treatment regime was escalated; in 463 patients (31.0%), no change occurred.</p><h3>Conclusions</h3><p>Despite established treatment guidelines, two-thirds of patients who sustained an FFP received neither SOM nor VitD in Germany. Patients with prefracture SOM treatment sustained more unstable fractures requiring surgical intervention, possibly reflecting advanced disease severity or altered bone biomechanics. Secondary fracture prevention remains suboptimal, with one-third of patients not receiving treatment postfracture.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}