---
title: "Investigation and Treatment Rates After Minimal Trauma Fracture in Primary Care"
id: "pubmed-42437684"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42437684"
content_type: "clinical_feed_article"
specialty: "General"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42437684/"
doi: "10.1071/PY25206"
published_at: "2026-08-17T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Investigation and Treatment Rates After Minimal Trauma Fracture in Primary Care
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42437684
- **Specialty:** [General](https://medichelpline.com/clinical-feed/general.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42437684/)
- **DOI:** [10.1071/PY25206](https://doi.org/10.1071%2FPY25206)
- **Published At:** 2026-08-17T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Primary care physicians are central to **osteoporosis** prevention and secondary fracture prevention, but real-world practice may fall short of guidelines. - The INTERCEPT cluster-randomized trial alerted GPs about patients with potential minimal trauma fractures and provided best-practice osteoporosis guidance; a follow-up survey assessed GP decisions four weeks after the alert. - From 170 GP responses, 76 (44.7%) fractures were judged as **minimal trauma**, 60 (35.3%) as not minimal trauma, and 34 (20.0%) were uncertain. - Fractures involving the spine and fractures in older or female patients were more likely to be considered minimal trauma by GPs. - Despite classifying 76 fractures as minimal trauma, only 44 (57.9%) of those patients received a **DXA** scan and fewer than half (n = 34) started osteoporosis-directed treatment. - Common reasons for not initiating treatment despite considering the fracture minimal trauma included DXA T-scores above −2.5 SD and cases where DXA confirmation was still pending. - The authors conclude that rates of osteoporosis-directed investigation and treatment after minimal trauma fractures in primary care are below recommended levels and that reliance on DXA confirmation is a major barrier to guideline-concordant management. - The survey highlights a gap between observed primary care management and established osteoporosis secondary prevention recommendations.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 The University of Sydney, Bone Research Program, ANZAC Research Institute, Concord, NSW, Australia. * 2 Department of Endocrinology and Metabolism, Concord Hospital, Concord, NSW, Australia. * PMID: **42437684** * DOI: [ 10.1071/PY25206 ](https://doi.org/10.1071/py25206) Free article Item in Clipboard Randomized Controlled Trial # Investigation and treatment rates following minimal trauma fracture: results of a primary care physician survey M Wang et al. Aust J Prim Health. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Aust J Prim Health Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Aust+J+Prim+Health%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Aust+J+Prim+Health%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42437684/) . 2026 Aug 17;32(4):PY25206. doi: 10.1071/PY25206. ### Authors [M Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+M&cauthor_id=42437684)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42437684/#short-view-affiliation-1 "The University of Sydney, Bone Research Program, ANZAC Research Institute, Concord, NSW, Australia.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42437684/#short-view-affiliation-2 "Department of Endocrinology and Metabolism, Concord Hospital, Concord, NSW, Australia."), [A Auwyang](https://pubmed.ncbi.nlm.nih.gov/?term=Auwyang+A&cauthor_id=42437684)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42437684/#short-view-affiliation-1 "The University of Sydney, Bone Research Program, ANZAC Research Institute, Concord, NSW, Australia."), [A Das](https://pubmed.ncbi.nlm.nih.gov/?term=Das+A&cauthor_id=42437684)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42437684/#short-view-affiliation-1 "The University of Sydney, Bone Research Program, ANZAC Research Institute, Concord, NSW, Australia."), [M J Seibel](https://pubmed.ncbi.nlm.nih.gov/?term=Seibel+MJ&cauthor_id=42437684)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42437684/#short-view-affiliation-1 "The University of Sydney, Bone Research Program, ANZAC Research Institute, Concord, NSW, Australia.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42437684/#short-view-affiliation-2 "Department of Endocrinology and Metabolism, Concord Hospital, Concord, NSW, Australia.") ### Affiliations * 1 The University of Sydney, Bone Research Program, ANZAC Research Institute, Concord, NSW, Australia. * 2 Department of Endocrinology and Metabolism, Concord Hospital, Concord, NSW, Australia. * PMID: **42437684** * DOI: [ 10.1071/PY25206 ](https://doi.org/10.1071/py25206) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Primary care plays a critical role in osteoporosis prevention and management. As part of a larger randomised controlled trial involving patients who had sustained a potential osteoporotic fracture, we asked general practitioners (GPs) about their perspectives on secondary fracture prevention. **Methods:** The INTERCEPT trial, a cluster-randomised controlled trial, identified patients with potential minimal trauma fractures and alerted the patients' GPs to the fracture, along with best-practice guidelines for osteoporosis management. Four weeks following the alert, a survey assessed the GPs' views and decisions on osteoporosis-directed investigations and treatments. **Results:** Out of 170 responses, GPs considered 76 (44.7%) fractures as minimal trauma, 60 (35.3%) as not minimal trauma, and 34 (20%) as uncertain. Fractures were more likely to be considered minimal trauma if they involved the spine or if patients were older and/or female. A significant number of patients were not investigated or treated for osteoporosis despite the GP considering the fracture minimal trauma: only 44 of these 76 (57.9%) patients had a DXA (dual energy X-ray absorptiometry) scan, and less than half (n = 34) were commenced on osteoporosis-directed treatment. DXA T-scores above -2.5 s.d. or awaiting confirmation via a DXA scan were common reasons for not initiating treatment despite regarding the fracture as minimal trauma. **Conclusion:** Rates of osteoporosis-directed investigations and treatment after minimal trauma fractures in primary care are below recommended levels. There remains a gap between observed management practices and established guidelines. A major barrier appears to be the reliance on DXA for confirmation of osteoporosis despite the presence of a minimal trauma fracture. **Keywords:** GP; endocrinology; fracture; osteoporosis; primary care; secondary fracture prevention; survey. © 2026 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Rates of osteoporosis screening and treatment following vertebral fracture. ](https://pubmed.ncbi.nlm.nih.gov/30142455/) Barton DW, Behrend CJ, Carmouche JJ.Barton DW, et al.Spine J. 2019 Mar;19(3):411-417. doi: 10.1016/j.spinee.2018.08.004. Epub 2018 Aug 22.Spine J. 2019.PMID: 30142455 * [ Barriers to secondary fracture prevention in primary care. ](https://pubmed.ncbi.nlm.nih.gov/28664275/) Mendis AS, Ganda K, Seibel MJ.Mendis AS, et al.Osteoporos Int. 2017 Oct;28(10):2913-2919. doi: 10.1007/s00198-017-4131-z. Epub 2017 Jun 29.Osteoporos Int. 2017.PMID: 28664275 * [ Osteoporosis management in Australian general practice: an analysis of current osteoporosis treatment patterns and gaps in practice. ](https://pubmed.ncbi.nlm.nih.gov/32050909/) Naik-Panvelkar P, Norman S, Elgebaly Z, Elliott J, Pollack A, Thistlethwaite J, Weston C, Seibel MJ.Naik-Panvelkar P, et al.BMC Fam Pract. 2020 Feb 12;21(1):32. doi: 10.1186/s12875-020-01103-2.BMC Fam Pract. 2020.PMID: 32050909Free PMC article. * [ Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas. ](https://pubmed.ncbi.nlm.nih.gov/36321557/) Crider K, Williams J, Qi YP, Gutman J, Yeung L, Mai C, Finkelstain J, Mehta S, Pons-Duran C, Menéndez C, Moraleda C, Rogers L, Daniels K, Green P.Crider K, et al.Cochrane Database Syst Rev. 2022 Feb 1;2(2022):CD014217. doi: 10.1002/14651858.CD014217.Cochrane Database Syst Rev. 2022.Update in: [Cochrane Database Syst Rev. 2026 Feb 18;2:CD014217. doi: 10.1002/14651858.CD014217.pub2.](https://pubmed.ncbi.nlm.nih.gov/41705996/)PMID: 36321557Free PMC article.Updated. * [ Screening for the primary prevention of fragility fractures among adults aged 40 years and older in primary care: systematic reviews of the effects and acceptability of screening and treatment, and the accuracy of risk prediction tools. ](https://pubmed.ncbi.nlm.nih.gov/36945065/) Gates M, Pillay J, Nuspl M, Wingert A, Vandermeer B, Hartling L.Gates M, et al.Syst Rev. 2023 Mar 21;12(1):51. doi: 10.1186/s13643-023-02181-w.Syst Rev. 2023.PMID: 36945065Free PMC article. 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