Breaking the fragility fracture cycle

Excerpt

Fracture begets fracture. This phenomenon has been well-characterised in many prospective studies and summarised by meta-analyses [1, 2]; a prior fracture at least doubles a patient’s future fracture risk. Elevated fracture risk persists for up to 10 years after the initial fracture event [3] and is greatest during the first year after this [4]. Several studies have explored this phenomenon from the obverse view of fracture history in patients presenting to hospital with a hip fracture. In 1980, Gallagher and colleagues reported prior fracture history amongst patients presenting with hip fracture in Rochester, USA for the period 1965–1974 [5]. Sixty-eight percent of women and 59% of men had suffered at least one other fracture besides their hip fracture. More recent studies from the UK [6], USA [7] and Australia [8] have consistently reported that 45% or more of today’s hip fracture patients have a prior fracture history. …