There are several common fracture types recognized by expert committees as being due to osteoporosis. Other fractures are not traditionally said to be so, but remember that is simply an opinion not a fact.

Osteoporosis fractures are also called fragility fractures. They occur with very little bone. The fracture was unexpected given the trauma. The principal factor that differentiates a fracture due to osteoporosis and one due to trauma is the force that caused the fracture. The less force, the more likely it was osteoporosis. For example: 1) a fall from standing height = osteoporosis 2) a fall from a step latter = traumatic fracture

Most fractures (80%) that occur in white adults over age 40 irrespective of the cause are contributed to by osteoporosis.

The most common osteoporotic fractures are of the spine, wrist, and hip. Fractures of the pelvic, ankle, humeral and femur can also be due to osteoporosis.

Hip Fractures
Hip fractures are the most serious osteoporosis fracture

  • They are life threatening in the short term by blood clots, stroke, heart attack and infection
  • 20% of people with hip fracture die in the year after the fracture
  • 50% have to use a cane, walker of wheelchair post-fracture
  • 25% are not able to maintain their independence post-hip fracture and move to assisted living or a nursing home

 

Hip fractures are the second most common fracture due to osteoporosis after spine fractures

They are the most expensive osteoporotic fracture, all requiring hospitalization, and most major surgery.

Hip fracture patients are usually old and frail. Most have one or more serious comorbid medical condition that makes them high risk for any major surgical procedure

A significant number of patients treated in hospital for hip fracture experience acute complications of the fracture or its treatment, some of which are life threatening.

Most hospitals and orthopedists are highly skilled at managing these patients. A team approach is used to rapidly and as safely possible move the patient from the ER to the OR to PT and out of the hospital. Today this process is accomplished in under a week compared with over two weeks 20 years ago. Outcomes are better, complications are fewer, and costs have not increased.

Spine Fractures
Spine fractures known as vertebral compression fractures

  • Are the most common fracture due to osteoporosis
  • The majority  70% of spine fractures are silent
  • The pain due to a spine fracture usually occurs in the lower back and may radiate into the buttock
  • The pain is usually severe and the patient knows that something is different about the pain
  • OTC pain treatment is not very useful

 

Spine fractures cause shortening of the torso but your legs and arms remain the same length. This makes shopping for coats difficult and usually requires an alteration be made to the coat’s hem.

With conventional therapy of ice packs, pain medications and physical therapy the pain from spine fractures slowly resolves over 3 to 6 months in most people. In some, the pain becomes chronic but not severe.

Kyphoplasty is an outpatient surgical technique where bone cement is injected into the broken vertebral body forming a stabilizing cast from within. Pain relief is immediate in 3 out of 4 patients. In half the others, it is improved and in the rest, there is no benefit.

Studies show that the presence of one spine fracture predicts the occurrence of future spine fractures. The more spine fractures someone has the higher the risk for follow-up fractures.

Patients who suffer symptomatic vertebral compression fractures experience a 20% excess mortality spread over the next five years from the date of the fracture compared with their peers who have not had a spine fracture.

Peripheral fractures

  • Are less common than spine or hip fractures
  • Are not fatal
  • Are always painful
  • Can be temporarily disabling
  • May require surgery to repair
  • Surgical repair can be very expensive
  • Complex ankle, wrist and shoulder fractures may result in some degree of long-term disability

 

Modern treatment reduces the relative risk of all osteoporosis fractures by  >50%