The bone was mush. Pinning that hip fracture successfully took all the skill gained in years of surgeries. Sneaking this surgery in before office has made you late (again). Write orders, dictate the report, a quick word with the family, and…….Stop! Tell the family that the bone was mush! Add the diagnoses of Osteoporosis and Fragility Fracture! Treat the whole patient!
The only way to be certain that you do not have a Vitamin D deficiency is to test for 25-hydroxy Vitamin D level. This is a blood test. The test measures 25-hydroxy Vitamin D2, 25-hydroxy Vitamin D3, and Total 25-hydroxy Vitamin D. This test is not yet part of routine blood testing for everyone. It should be done more often.
Prolia (Denosumab) is the newest type of Antiresorptive medication for Osteoporosis. Like the other Antiresorptive medications, Prolia slows down the cells that eat away bone, but in a different way. A simple way of looking at Prolia is to think of it as “birth control” for the cells that eat away bone. See my post about “Osteoclasts Gone Wild”.