Warning signs of a fragility fracture

(menopausal women, men age 50-64 yr*)

  • Chronic pain1
  • Reduced mobility
    • Fragility fractures have had lasting deficits on patients’ post-fracture ability to move independently.2†
  • Loss of height1
    • Among men and women with the most severe kyphosis, ~36% have underlying vertebral fractures3‡
      • Vertebral Fracture Assessment – An incident fracture can be diagnosed if any of 3 vertebral heights (anterior, middle or posterior) decreased by more than 20% and by at least 4 mm compared with the previous film
  • Disability1
woman with normal spine and woman with a spine with kyphosis1
  • Disability1
woman with normal spine and woman with a spine with kyphosis

Canadian Multicentre Osteoporosis Study (CaMos), a prospective, 10-year study of patients with osteoporosis; used health utilities index (HUI) since its inception. Data has shown that men with hip fractures had substantial deficits in mobility: HUI2 score: -0.20 from baseline (0.981 [0.08]) to year 5.2†

Clinical risk factors of a fragility fracture

(menopausal women, men age 50-64 yr*)

  • Personal history of a fragility fracture after age 40 yr5
    • A previous fracture denotes more accurately a previous fracture in adult life occurring spontaneously, or a fracture arising from trauma which, in a healthy individual, would not have resulted in a fracture6
  • Parental hip fracture5
  • Current smoking5
  • Prolonged use of glucocorticoids
  • Rheumatoid arthritis5
  • An osteoporosis diagnosis or a secondary osteoporosis diagnosis (the patient has a disorder strongly associated with osteoporosis such as type I (insulin dependent) diabetes, osteogenesis imperfecta in adults, untreated long-standing hyperthyroidism, hypogonadism or premature menopause (<45 years), chronic malnutrition, or malabsorption and chronic liver disease)5,6
  • Use of other high-risk medications5**
  • Vertebral fracture or osteopenia identified on radiography
  • High alcohol intake (3 or more units of alcohol daily)5,6
  • Low body weight (< 60 kg) or major weight loss (> 10% of body weight at age 25 yr)5
x-rayed pelvis region including hips, spine and femur

A fracture is one of the most significant risk factors for predicting future fracture7

Risk of another fracture within 1 year:

After vertebral fracture:

20% risk7

After hip fracture:

5%-10% risk7

Imminent fracture risk

It has been reported that the majority of subsequent fragility fractures tended to occur within the initial 2 years after an incident fracture.8

16%

after hip fracture††

(index fractures n=31,613)

20%

after forearm
(radius or ulna) fracture
††

(index fractures n=4,828)

19%

after humerus fracture††

(index fractures n=13,237

CLOSE THE OSTEOPOROSIS CARE GAP:

Prevent fragility fractures and their negative consequences5

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