Arch Orthop Trauma Surg (2007) 127:1–2 DOI 10.1007/s00402-006-0262-y 123 EDITORIAL Osteoporotic fracture management: closing the gap of knowledge J. Goldhahn · M. Blauth Received: 16 November 2006 / Published online: 7 December 2006  Springer-Verlag 2006 Patients with osteoporosis suVer twice. First, they have a higher risk of experiencing a fracture compared to non-osteoporotic individuals. Second, they have a higher risk of experiencing a complication during the course of fracture healing. The Wrst fact is well established, with many factors described, leading to the increased risk of fracture [3]. Subsequently, diVerent treatment modes were developed and introduced to prevent fractures caused by osteoporosis [1]. Findings were published in high-ranked scientiWc journals, especially in the Weld of bone biology [4]. Journals such as Osteoporo- sis International, Progress in Osteoporosis and Archives of Osteoporosis have a special focus on this topic. Conversely, there is a limited body of knowledge regarding the increased risk of complications during fracture healing. Although recent publications show that osteoporotic patients suVer from signiWcantly increased disability after fracture—even when surgi- cally treated—the reasons are largely unknown [2]. Increased morbidity of these patients cannot only be explained by age and comorbidity. Biomechanical Wnd- ings suggest that reduced local bone quality may be a risk factor for complications during fracture treatment. However, the association between complex bone changes in osteoporosis and implant performance is not well understood so far. Lack of information exchange between the two major specialties, the physi- cians and the orthopaedic surgeons, might be one rea- son for this. The hypothesis is illustrated by a recent MESH term search (November 2006). A Medline search for the MESH term osteoporosis revealed 28,891 hits, the search for the MESH term fracture Wxa- tion 33,496. However, only 373 hits included both oste- oporosis and fracture Wxation. There is a growing number of orthopaedic surgeons who are aware of the problem of fracture Wxation in osteoporotic bone and related problems of prevention and pharmaceutical treatment. Numerous initiatives like the Osteoporotic Fracture Campaign, a joint initia- tive of the International Society of Fracture Repair (ISFR) and the International Osteoporosis Founda- tion, the Clinical Priority Area Fracture Fixation in Osteoporotic bone, funded by AO Foundation and many others show that surgeons are willing to approach the topic. Several supplements were pub- lished that highlight the need of adequate treatment, their challenges and current solutions. The journal Archive of Orthopaedic and Trauma Surgery now oVers a regular platform for publication of articles dealing with all aspects of fracture treatment in osteo- porotic patients. Original research, reviews and invited papers about applied diagnostics, fracture Wxation and healing, co-managed care, secondary prevention and new solutions will form the base for the new section “Osteoporotic fracture management”. Researchers and clinicians are called for submission of their contri- butions to the journal. The new section should contrib- ute to a better care for osteoporotic patients by closing J. Goldhahn (&) Schulthess Clinic Zurich, Lengghalde 2, 8008 Zurich, Switzerland e-mail: joerg.goldhahn@kws.ch M. Blauth Department of Trauma Surgery and Sports Medicine, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria