[The importance of osteoporosis in the treatment of fractures and orthopedic-surgical possibilities].

The treatment of osteoporosis-related fractures can be difficult, when secure fixation and stable osteosynthesis is obtained in frail trabecular and cortical bone. In the case of defects, bone grafting and substitutes may be needed to reinforce osteosynthesis and promote fracture healing, which may be delayed. The structural grafts may be biologically inert or osteoconductive, but also osteoinductive, and various osteoinductive growth factors and hormones could be a supplement to treatment. Several types of osteosyntheses have improved the clinical outcome, among them: sliding hip screw, neck screws, intramedullary nails with neck screw, retrograde intramedullary nails, external fixation, cannulated screws, various plates, tension band wiring, threaded K-pins, and to some extent arthroplasties and reconstructive spine instrumentation. The goal in the treatment of osteoporosis-related fractures is to restore functional abilities as soon as possible, and the prevention of subsequent fractures is indicated.