Published online Apr 18, 2016. doi: 10.5312/wjo.v7.i4.218
Peer-review started: November 3, 2015
First decision: November 30, 2015
Revised: December 19, 2015
Accepted: December 29, 2015
Article in press: January 4, 2016
Published online: April 18, 2016
Processing time: 166 Days and 1.5 Hours
Hip fractures are an acute and worsening public health problem. They mainly affect elderly people, a population group that is highly vulnerable to disease and accidents, and to falls in particular. Although it has been suggested that osteoporosis is the cause of hip fractures, they mainly occur after a fall has been suffered. The underlying causes of a fall are not related to osteoporosis, although pharmaceutical companies have coined the term “osteoporotic fracture” for hip fractures in the elderly. Drug treatments for osteoporosis have not diminished the frequency of these injuries, nor have they prevented the occurrence of a subsequent fracture. Since pharmaceutical interests require osteoporosis to be considered a disease, rather than a normal condition of senescence, they go further by assuming that treatment for osteoporosis is essential, and that this policy will diminish the incidence of hip fractures. On the other hand, the origin and treatment of conditions that may be conducive to provoking falls are very difficult to elucidate. In this paper, we consider some of the medical and social problems that arise in this area, as well as conflicts of interest regarding the aetiopathogenesis and prevention of hip fracture, and propose a new paradigm for the prevention of falls.
Core tip: This paper rejects the role of osteoporosis in the pathogenesis of hip fracture and proposes medically-based political action to support new omics technologies to detect the risk of falls by elderly people, by detracting resources from those currently employed in the treatment of osteoporosis.