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Global Perspectives on the Care Gap in Fragility Fracture Management: Bridging Evidence and Clinical Practice.

Created on 05 Sep 2026

Authors

Irewin Tabu, Elizabeth Armstrong, Matthew L Costa, Frede Frihagen, Jay Magaziner, Joon-Kiong Lee, Takeshi Sawaguchi

Published in

The Journal of bone and joint surgery. American volume. Sep 04, 2026. Epub Sep 04, 2026.

Abstract

➢ Fragility fracture care remains suboptimal worldwide despite strong evidence supporting timely surgery, orthogeriatric care, early mobilization, unrestricted weight-bearing, and secondary fracture prevention.➢ International quality standards and registry-based audits have translated this evidence into measurable indicators that improve care in many high-income health-care systems.➢ Implementation in low- and middle-income countries (LMICs) is limited primarily by health-system constraints, including workforce shortages, delayed presentation, limited infrastructure, and fragmented care pathways, rather than by lack of evidence.➢ Emerging initiatives demonstrate that evidence-based quality standards can be successfully adapted to local contexts while preserving their core clinical principles.➢ Orthopaedic surgeons have a central role in leading multidisciplinary care, promoting secondary fracture prevention, and driving quality improvement across the entire fragility fracture pathway.➢ Future progress depends on strengthening health systems, embedding auditing and certification programs, and implementing context-sensitive quality standards that bridge the gap between evidence and routine.

PMID:
42696559
Bibliographic data and abstract were imported from PubMed on 05 Sep 2026.

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