Todd P Krell, MD
Fellow of the American Academy of Orthopaedic Surgeons
http://orthodoc.aaos.org/ToddKrellMD
Westfield Orthopedic Group
541 East Broad Street
Westfield, NJ 07090
Phone: (908)232-3879  | Fax: (908)232-5789
Copyright 2007 American Academy of Orthopaedic Surgeons
First Fracture May Be a Warning Sign

A fracture can be more than a just a broken bone. It may be a warning sign that you have osteoporosis.

Osteoporosis, or "porous bone" is a medical condition that weakens bone by making it more porous and less dense. Bone density is one of the factors that determine bone strength, so individuals with low bone density have a higher risk for fracture and refracture.

Osteoporosis is a contributing factor in as many as 1.5 million fractures each year, including:

  • About 300,000 hip fractures
  • About 700,000 vertebral (spine) fractures
  • About 250,000 wrist fractures
  • About 300,000 fractures at other sites

The risk of a serious fracture can double after a first fracture in certain high-risk groups. Additionally, many patients, particularly those who suffer hip fractures, are at high risk for premature death or loss of independence after the fracture. Consider these facts:

  • One out of four people who have an osteoporotic hip fracture will need long-term nursing home care.
  • Half of those who experience osteoporotic hip fractures are unable to walk without assistance.
  • Those who experience the trauma of an osteoporotic hip fracture have a 24% increased risk of dying within one year following the fracture.
  • Clearly identifying osteoporosis early and initiating treatment is essential.
Who Should Be Concerned?

Osteoporosis should not just be a concern for aging white women. Recent data indicates that osteoporosis occurs in all racial groups.

  • Hispanic women may be among those at highest risk. Between 13 percent and 16 percent of Hispanic women have osteoporosis. As many as 49% of Mexican-American women 50 years of age or older have low bone density.
  • Although the rate of hip fractures is lower in Asian-American women, the rate of vertebral fractures is about equal between Asian-American and Caucasian women.
  • About 10 percent of African-American women over 50 have osteoporosis. An additional 30 percent have low bone density. Between 80 percent and 95 percent of all fractures experienced by African-American women over age 64 are related to osteoporosis.

Men should also be concerned about osteoporosis. Approximately one in eight men will have an osteoporotic fracture. Men with a history of hypogonadism, thyroid dysfunction, long-term steroid therapy, high alcohol consumption or low physical activity are especially at risk. One-third of all hip fractures experienced by men are related to osteoporosis, and one-third of these men will die within the first year after the fracture.

A fracture in adulthood does not always mean an individual has osteoporosis. However, every adult who suffers a fracture should discuss the need for bone density testing with a physician. If your bone density is low, you may need additional medical tests. Medical conditions other than osteoporosis can cause low bone density.

What Can Be Done?

There is no specific cure for osteoporosis. However, if you have been diagnosed with it, diet and lifestyle changes can reduce your risk of refracture. You should also discuss medical therapy with your physician. Even individuals without osteoporosis should follow these four simple guidelines.

  • Make sure you get enough calcium and Vitamin D in your diet. The National Academy of Sciences recommends 400 to 800 units of Vitamin D and 1,000 to 1,500 mg of Calcium per day.
  • Participate in activities that will strengthen bone and muscle. Regular exercise is one of the best things you can do to prevent osteoporosis. Weight-bearing exercises like walking, jogging and tennis and low-impact exercise classes are best for building and maintaining strong bones.
  • Because falls are the most common cause of fractures, do some balance activities to reduce your risk. The benefits of tai chi in particular have been documented. Tai chi decreases falls among older individuals by 47%.
  • If you have had a broken bone, talk to your doctor about a bone density test. You may also wish to discuss other steps you can take to reduce the risk of a second fracture.
Last reviewed: July 2007
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS "Find an Orthopaedist" program on this website.
Copyright 2007 American Academy of Orthopaedic Surgeons
Related Topics
Fractures (Broken Bones) (http://orthoinfo.aaos.org/topic.cfm?topic=A00139)
Osteoporosis (http://orthoinfo.aaos.org/topic.cfm?topic=A00232)
Osteoporosis Prevention (http://orthoinfo.aaos.org/topic.cfm?topic=A00315)
What Is Your Risk for Osteoporosis? (http://orthoinfo.aaos.org/topic.cfm?topic=A00126)
OrthoInfo
The American Academy of Orthopaedic Surgeons
6300 N. River Road
Rosemont, IL 60018
Phone: 847.823.7186
Email: orthoinfo@aaos.org

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