Evidence map›Paper›PMID 40970965›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

Should we consider ankle fractures as osteoporotic fractures?

Steffi S I Falk, Thomas Mittlmeier

Abstract read
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. The Diagnosis, Treatment, and Aftercare of Ankle Fractures.Deutsches Arzteblatt international · 2026
    Review
  3. Burden of accumulating fragility fractures on health service usage and costs among post-menopausal women.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Article
  4. Author response to letter to the editor to ankle fractures: A pragmatic opportunity for osteoporosis case finding (OSIN-D-25-01889).Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Steffi S I FalkClinic of Trauma, Hand and Reconstructive Surgery, University of Rostock, Schillingallee 35, 18057, Rostock, Germany. steffi.falk@med.uni-rostock.de.ORCID http://orcid.org/0000-0003-0584-343X
Thomas MittlmeierClinic of Trauma, Hand and Reconstructive Surgery, University of Rostock, Schillingallee 35, 18057, Rostock, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Since ankle fractures are common fractures in the lower limb, it is worth exploring their potential association with osteoporosis. As part of the research, patients with ankle fractures were screened for osteoporosis to assess its potential for identifying patients with osteoporosis (osteoporosis cases). Consequently, screening should be included as part of fracture management. Ankle fractures are part of the orthopaedic surgeon's daily routine. They are the most common lower limb fractures in the elderly. The absence of an age peak, such as that seen in distal radius fractures, makes it difficult to distinguish between fractures that are likely to be related to osteoporosis and those that are not. The DVO (German Osteological Association) guideline, published in 2017, mainly mentions exceptions for osteoporotic fractures, such as ankle fractures. This study examined patients with ankle fractures to assess whether this fracture type can be used for identifying osteoporosis. PURPOSE: Considering the fact that ankle fractures are the most prevalent fractures in the lower extremity, it is worth investigating what proportion of these fractures are related to osteoporosis. As part of the research, patients with ankle fractures underwent screening for osteoporosis to determine its potential utility in identifying patients with osteoporosis.

methodThe present study included all patients aged 45 or older with ankle fractures that occurred within a period of 24 months. Participants were asked about their osteoporosis risk factors. The Fracture Risk Assessment Tool® was used to assess eligibility for treatment. The information from the questionnaire was used to determine whether there was an indication for diagnostic testing for osteoporosis according to the DVO guideline. It was also recorded whether, based on the risk factors assessed, the patient had an indication for osteoporosis therapy.

resultsA total of 131 patients were enrolled. The average age was 65 years. Osteoporosis screening was necessary for 61 percent. Based on age, 85% of patients aged 60 years or older were recommended for osteoporosis screening. Fifty-five percent of the patients aged 61 years and above had an indication for a specific therapy. The treatment gap in patients requiring specific therapy was 97%.

conclusionScreening should be provided and conducted as part of fracture management due to the substantial number of patients who require screening. Ankle fractures could help to close the existing treatment gap of 78-80% in Germany.

trial registrationClinicalTrials.gov Identifier: DRKS00028085.

Indexed as

Ankle FracturesOsteoporosisOsteoporotic FracturesAgedAged, 80 and overFemaleHumansMaleMass ScreeningMiddle AgedAnkle fractureElderlyFractureOsteoporosisTherapy gapVitamin D

Identifiers

PMID40970965
PMCPMC12628414

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.