Published on: 10-Jul-2023
A broken bone at any age can be a painful experience, but for post-menopausal women and senior men, it may signal more significant bone health issues. New research suggests that when the elderly break bones, even as the result of a fall or other trauma, fragile bones are often to blame and further evaluation of overall bone health should be part of the overall treatment plan.
Fractures Increase Risk of Subsequent Fractures
As part of the study, researchers followed more than 7,000 post-menopausal women who had sustained a fracture for eight years and cataloged the incidence of subsequent fractures. Then, they compared their risk of having a second fracture to 66,874 of their peers who had not suffered an initial fracture. Among the women who sustained a fracture from a small trauma, which is indicative of weakened bones, the risk of having another fracture increased by more than 50 percent. And, among women whose fracture was the result of a traumatic accident, the risk was 25 percent greater than expected, based on the cohort of women with no initial fracture.
The study’s results indicated that both nontraumatic and traumatic initial fractures were associated with the risk of a subsequent fracture. Yet, among Medicare patients who sustain a hip or spinal fracture, only 9 percent were tested for bone loss and offered treatment to help prevent another fracture.2 Alarmingly, within three years 20 percent suffered another fracture, proving that doctors must not only treat the initial injury, but also assess overall bone health.
Bone Health Evaluation an Integral Part of Treatment
These results are important because often, fractures that result from accidents often do not trigger further evaluation for osteoporosis. The compelling evidence indicates that postmenopausal women who fracture, regardless of the level of trauma, should have their bone density evaluated, as high-trauma and low-trauma fractures show similar associations with low bone mineral density.
In addition, older men also see a higher risk of second fractures. Studies document that older men who suffered a high-trauma fracture were as likely to have low bone densities as men with a low-trauma fracture and were also at risk of a future fracture.3 Men also develop osteoporosis, though generally later in life than women, and their bone health should not be overlooked.
Following a traumatic or non-traumatic bone fracture, a thorough evaluation of overall bone health should be an integral part of treatment. After all, an ounce of prevention is worth a pound of cure.
Authored by Zach Meeker, Research Assistant for Midwest Orthopaedics at Rush University Medical Center
References
1 Crandall CJ, Larson JC, LaCroix AZ, et al. Risk of Subsequent Fractures in Postmenopausal Women After Nontraumatic vs Traumatic Fractures. JAMA Intern Med. 2021;181(8):1055–1063. doi:10.1001/jamainternmed.2021.2617
2 Brody, J.E. (2020) After a Broken Bone, the Risk of a Second Fracture. New York Times
3 Ensrud, K.E., Blackwell, T.L., Cawthon, P.M., et. al. (2016) Degree of trauma differs for major osteoporotic fracture events in older men versus older women. Journal of Bone and Mineral Research.
