Fragility or Osteoporosis Fractures

What is a fragility or osteoporosis fracture?

Fragility is a state of being delicate or breakable and this type of fracture is a break in the bone resulting from a fall from standing height or less. In most people, a fall of this kind should not result in a broken bone. A fragility fracture is often an indicator that there is an underlying weakness of the bones, known as osteoporosis.

Why does this happen?

There are several reasons why bones can weaken as you get older. These include chronic diseases affecting your lungs, bowels and kidneys, and certain medications such as steroids. Being underweight, smoking, decreases calcium intake, vitamin D deficiency and lack of physical activity can contribute. If you have gone through the menopause, your bones will be more fragile and may break more easily.

What can I do to prevent further fractures?

If you have ever had a broken wrist, spine or hip bone after a fall from standing and you are not on bone protective medication, your chance of breaking a bone next time you have an injury is high compared to the rest of the population. If you break a long bone such as your hip or multiple bones, your chance of returning home to your previous level of function can become much lower.

In order to increase your chances of staying well, kindly arrange routine appointment with your doctor for an assessment of your bone health. This might include blood tests to replace any deficiencies in minerals or vitamins, an assessment of your risk of falling and an assessment of your bone strength using the FRAX (Fracture Risk Assessment Tool) score or a DEXA scan. At the end you may be offered treatment if required in the form of medication, physiotherapy, or home modifications as well as regular follow up to assess your progress.

How will my bone strength be assessed?

Your risk of having another fracture can be calculated using a FRAX tool. This looks at various risk factors, including the ones described above.

• If you have a low score, you do not need further tests.
• If you have a medium score, you will be referred for a scan of your bones called a DEXA. This is a scan used to diagnose osteoporosis and will determine whether to start bone protective medication.
• If you have a high score, you may be started on bone protection without a scan.

Is there anything else I can do to make my bones stronger?

Having a good diet with plenty of calcium and vitamin D will help strengthen your bones, as well as maintaining a healthy weight and exercising regularly, if possible. Cutting down on smoking are advised; if you need any further help with this, contact your doctor who will be able to guide you further.

Dr. Umar Zia Khan
(Orthopedic Surgeon)