• 1
    British Orthopaedic Association, British Geriatrics Society. The care of patients with fragility fracture 2nd ed. [Internet].: London: British Orthopaedic Association; Sep [cited 2012 Jul 9]. Available from: 2007.
  • 2
    Lonnroos E, Kautiainen H, Karppi P, Hartikainen S, Kiviranta I, Sulkava R. Incidence of second hip fractures. A population-based study. Osteoporos Int. 2007; 18(9): 127985.
  • 3
    Nymark T, Lauritsen JM, Ovesen O, Rock ND, Jeune B. Short time-frame from first to second hip fracture in the Funen County Hip Fracture Study. Osteoporos Int. 2006; 17(9): 13537.
  • 4
    Lawrence TM, Wenn R, Boulton CT, Moran CG. Age-specific incidence of first and second fractures of the hip. J Bone Joint Surg Br. 2010; 92(2): 25861.
  • 5
    Black DM, Delmas PD, Eastell R, Reid IR, Boonen S, Cauley JA, Cosman F, Lakatos P, Leung PC, Man Z, Mautalen C, Mesenbrink P, Hu H, Caminis J, Tong K, Rosario-Jansen T, Krasnow J, Hue TF, Sellmeyer D, Eriksen EF. Cummings SR; HORIZON Pivotal Fracture Trial. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007; 356(18): 180922.
  • 6
    Lyles KW, Colon-Emeric CS, Magaziner JS, Adachi JD, Pieper CF, Mautalen C, Hyldstrup L, Recknor C, Nordsletten L, Moore KA, Lavecchia C, Zhang J, Mesenbrink P, Hodgson PK, Abrams K, Orloff JJ, Horowitz Z, Eriksen EF, Boonen S. HORIZON Pivotal Fracture Trial. Zoledronic acid and clinical fracture and mortality after hip fracture. N Engl J Med. 2007; 357(18): 1799809.
  • 7
    Gallagher JC, Melton LJ, Riggs BL, Bergstrath E. Epidemiology of fractures of the proximal femur in Rochester, Minnesota. Clin Orthop Relat Res. 1980 Jul-Aug; (150): 16371.
  • 8
    Port L, Center J, Briffa NK, Nguyen T, Cumming R, Eisman J. Osteoporotic fracture: missed opportunity for intervention. Osteoporos Int. 2003; 14(9): 7804.
  • 9
    McLellan A, Reid D, Forbes K, Reid R, Campbell C, Gregori A, Raby N, Simpson A. Effectiveness of strategies for the secondary prevention of osteoporotic fractures in Scotland (CEPS 99/03) [Internet]. Glasgow, Scotland: NHS Quality Improvement Scotland; [cited 2012 Jul 9]. Available from: 2004.
  • 10
    Edwards BJ, Bunta AD, Simonelli C, Bolander M, Fitzpatrick LA. Prior fractures are common in patients with subsequent hip fractures. Clin Orthop Relat Res. 2007; 461: 22630.
  • 11
    Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000; 15(4): 72139.
  • 12
    Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, Eisman J, Fujiwara S, Garnero P, Kroger H, McCloskey EV, Mellstrom D, Melton LJ, Pols H, Reeve J, Silman A, Tenenhouse A. A meta-analysis of previous fracture and subsequent fracture risk. Bone. 2004; 35(2): 37582.
  • 13
    Johnell O, Kanis JA, Oden A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jonsson B. Fracture risk following an osteoporotic fracture. Osteoporos Int. 2004; 15(3): 1759.
  • 14
    Center JR, Bliuc D, Nguyen TV, Eisman JA. Risk of subsequent fracture after low-trauma fracture in men and women. JAMA. 2007; 297(4): 38794.
  • 15
    McLellan AR, Gallacher SJ, Fraser M, McQuillian C. The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int. 2003; 14(12): 102834.
  • 16
    Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006; 17(12): 172633.
  • 17
    Office of the Surgeon General. Bone health and osteoporosis: a report of the Surgeon General [Internet]. Washington, DC: U.S. Department of Health and Human Services; [cited 2012 Jul 9]. Available from:
  • 18
    Elliot-Gibson V, Bogoch ER, Jamal SA, Beaton DE. Practice patterns in the diagnosis and treatment of osteoporosis after a fragility fracture: a systematic review. Osteoporos Int. 2004; 15(10): 7678.
  • 19
    Giangregorio L, Papaioannou A, Cranney A, Zytaruk N, Adachi JD. Fragility fractures and the osteoporosis care gap: an international phenomenon. Semin Arthritis Rheum. 2006; 35(5): 293305.
  • 20
    Shi N, Foley K, Lenhart G, Badamgarav E. Direct healthcare costs of hip, vertebral, and non-hip, non-vertebral fractures. Bone. 2009; 45(6): 108490.
  • 21
    Song X, Shi N, Badamgarav E, Kallich J, Varker H, Lenhart G, Curtis JR. Cost burden of second fracture in the US Health System. Bone. 2011; 48(4): 82836.
  • 22
    Dell R, Greene D, Schelkun SR, Williams K. Osteoporosis disease management: the role of the orthopaedic surgeon. J Bone Joint Surg Am. 2008; 90 (Suppl 4): 18894.
  • 23
    Sander B, Elliot-Gibson V, Beaton DE, Bogoch ER, Maetzel A. A coordinator program in post-fracture osteoporosis management improves outcomes and saves costs. J Bone Joint Surg Am. 2008; 90(6): 1197205.
  • 24
    Marsh D, Akesson K, Beaton DE, Bogoch ER, Boonen S, Brandi ML, McLellan AR, Mitchell PJ, Sale JE, Wahl DA. IOF CSA Fracture Working Group. Coordinator-based systems for secondary prevention in fragility fracture patients. Osteoporos Int. 2011; 22(7): 205165.
  • 25
    Harrington JT, Barash HL, Day S, Lease J. Redesigning the care of fragility fracture patients to improve osteoporosis management: a health care improvement project. Arthritis Rheum. 2005; 53(2): 198204.
  • 26
    Sale JE, Beaton D, Posen J, Elliot-Gibson V, Bogoch E. Systematic review on interventions to improve osteoporosis investigation and treatment in fragility fracture patients. Osteoporos Int. 2011; 22(7): 206782.
  • 27
    Cooper MS, Palmer AJ, Seibel MJ. Cost-effectiveness of the Concord Minimal Trauma Fracture Liaison service, a prospective, controlled fracture prevention study. Osteoporos Int. 2012; 23(1): 97107.
  • 28
    McLellan AR, Wolowacz SE, Zimovetz EA, Beard SM, Lock S, McCrink L, Adekunle F, Roberts D. Fracture liaison services for the evaluation and management of patients with osteoporotic fracture: a cost-effectiveness evaluation based on data collected over 8 years of service provision. Osteoporos Int. 2011; 22(7): 208398.
  • 29
    Slater M, Sujic R, Sale JE, Bogoch E, Beaton D. Getting men on care: no evidence of gender inequity in osteoporosis testing and treatment initiation in a coordinator-based fragility fracture screening program. Canadian Orthopaedic Association Annual Meeting Abstract Supplement 2011; 1: 116-7 [Internet]. Westmount, Quebec, Canada: Canadian Orthopaedic Association; 2011 [cited 2012 Jul 9]. Available from:
  • 30
    Cranney A, Guyatt G, Griffith L, Wells G, Tugwell P, Rosen C. Osteoporosis Methodology Group and The Osteoporosis Research Advisory Group. Meta-analyses of therapies for postmenopausal osteoporosis. IX: Summary of meta-analyses of therapies for postmenopausal osteoporosis. Endocr Rev. 2002; 23(4): 5708.
  • 31
    Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, Bauer DC, Genant HK, Haskell WL, Marcus R, Ott SM, Torner JC, Quandt SA, Reiss TF, Ensrud KE. Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet. 1996; 348(9041): 153541.
  • 32
    Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, Hodsman AB, Eriksen EF, Ish-Shalom S, Genant HK, Wang O, Mitlak BH. Effect of parathyroid hormone (1–34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001; 344(19): 143441.
  • 33
    Reginster J, Minne HW, Sorensen OH, Hooper M, Roux C, Brandi ML, Lund B, Ethgen D, Pack S, Roumagnac I, Eastell R. Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. Osteoporos Int. 2000; 11(1): 8391.
  • 34
    Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, Delmas P, Zoog HB, Austin M, Wang A, Kutilek S, Adami S, Zanchetta J, Libanati C, Siddhanti S, Christiansen C. FREEDOM Trial. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009; 361(8): 75665.
  • 35
    Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, Chesnut CH 3rd, Brown J, Eriksen EF, Hoseyni MS, Axelrod DW, Miller PD. Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. JAMA. 1999; 282(14): 134452.
  • 36
    McClung MR, Geusens P, Miller PD, Zippel H, Bensen WG, Roux C, Adami S, Fogelman I, Diamond T, Eastell R, Meunier PJ, Reginster JY. Hip Intervention Program Study Group. Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med. 2001; 344(5): 33340.
  • 37
    Reginster JY, Seeman E, De Vernejoul MC, Adami S, Compston J, Phenekos C, Devogelaer JP, Curiel MD, Sawicki A, Goemaere S, Sorensen OH, Felsenberg D, Meunier PJ. Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis: Treatment of Peripheral Osteoporosis (TROPOS) study. J Clin Endocrinol Metab. 2005; 90(5): 281622.
  • 38
    Chami G, Jeys L, Freudmann M, Connor L, Siddiqi M. Are osteoporotic fractures being adequately investigated? A questionnaire of GP & orthopaedic surgeons. BMC Fam Pract. 2006; 7: 7.
  • 39
    National Bone Health Alliance. Eye on bone health: secondary fracture prevention initiative Vol. 1 Washington DC: National Bone Health Alliance; p. 1. 2011.
  • 40
    International Osteoporosis Foundation. Capture the fracture. Nyon, Switzerland: International Osteoporosis Foundation; 2012 [cited 2012 Jul 9]. Available from:
  • 41
    Osteoporosis Canada. Osteoporosis: towards a fracture free future [Internet]. Toronto, Ontario, Canada: Osteoporosis Canada; Mar [cited 2012 Jul 9]. Available from: 2011.
  • 42
    Osteoporosis Canada. Osteoporosis patient bill of rights. Toronto, Ontario, Canada: Osteoporosis Canada; 2011.
  • 43
    National Osteoporosis Society. Our manifestos. Protecting fragile bones: a strategy to reduce the impact of osteoporosis and fragility fractures in England/Scotland/Wales/Northern Ireland [Internet]. Bath, UK: National Osteoporosis Society; [cited 2012 Jul 9]. Available from: 2009.
  • 44
    National Osteoporosis Society. Care services minister attends vital falls and fractures summit. Bath, UK: National Osteoporosis Society.
  • 45
    American Society of Bone and Mineral Research Task Force on Systems-Based Approaches to Secondary Fracture prevention. Systems-based approaches to secondary fracture prevention: doing something that actually works. ASBMR 2011. 2011 Annual Meeting, San Diego Convention Center, San Diego, CA, USA. Washington, DC: American Society of Bone and Mineral Research; 2011.
  • 46
    Foundation AO. Fragility fractures and orthogeriatric comanagement course in Davos. Davos, Switzerland: AO Foundation; 2011.
  • 47
    International Society for Fracture Repair. Osteoporotic fracture campaign. London: International Society for Fracture Repair; 2011.
  • 48
    International Osteoporosis Foundation. Enormous growth in use of WHO Fracture Risk Assessment Tool (FRAX®). Nyon, Switzerland: International Osteoporosis Foundation; 2012.
  • 49
    American Academy of Orthopaedic Surgeons. Position statement: recommendations for enhancing the care of patients with fragility fractures. Rosemont, IL, USA: American Academy of Orthopaedic Surgeons; 2009.
  • 50
    Bunta AD. It is time for everyone to own the bone. Osteoporos Int. 2011; 22 (Suppl 3): 47782.
  • 51
    US Bone and Joint Decade. Osteoporosis education kit to prevent future fractures [Internet]. USBJD Newsletter. 2007 May/June;9(1). [cited 2012 Jul 9]. Available from;
  • 52
    Fragility Fracture Network. FFN: a global network to improve fragility fracture management and prevention [Internet]. Glattbrugg, Switzerland: Fragility Fracture Network (FFN); 2011; [cited 2012 Jul 9]. Available from:
  • 53
    Department of Health. Falls and fractures: effective interventions in health and social care. London: Department of Health, NHS; [cited 2012 Jul 9]. Available from: 2009.
  • 54
    Dell R, Greene D. Is osteoporosis disease management cost effective?. Curr Osteoporos Rep. 2010; 8(1): 4955.
  • 55
    Newman ED, Ayoub WT, Starkey RH, Diehl JM, Wood GC. Osteoporosis disease management in a rural health care population: hip fracture reduction and reduced costs in postmenopausal women after 5 years. Osteoporos Int. 2003; 14(2): 14651.
  • 56
    Ministry of Health and Long-term Care, Ontario Women's Health Council, Osteoporosis Canada. Ontario Osteoporosis Strategy [Internet]. Toronto, Ontario, Canada: Osteoporosis Canada; [cited 2012 Jul 9]. Available from: 2010.
  • 57
    Center JR, Bliuc D, Nguyen ND, Nguyen TV, Eisman JA. Osteoporosis medication and reduced mortality risk in elderly women and men. J Clin Endocrinol Metab. 2011; 96(4): 10064.