October 30, 2002
Fragility Fracture, Osteoporosis and YOU.

It is an unwelcome thought that the slip or fall that caused you to break a bone could be more than an unlucky turn of events. If you are reading this page, you are on your way to finding out more about bone health.

The following three statements are associated with fractures or breaks related to low bone mass or osteoporosis.

• The most common sites for fragility fractures (broken bone) are in your wrist, shoulder, back or hip.
• This type of break results from minimal trauma or stress like when you had a fall from standing height or less that caused you to break a bone (even if you seemed to fall down hard)
• You are most likely to have thinning bones that result in this type of break if you are over 50 years old.

Fractures or broken bones related to thinning bones are very common. If the above statements match you with your broken bone, please continue to learn more about bone health. Your doctor may have already told you that your broken bone is called a fragility fracture.

The Facts About Fragility Fractures (Broken Bones) and Osteoporosis:

• More than 50% of the broken bones in men over 50 and women over 40 years of age are the result of thinning bones related to osteoporosis (Latin for porous bones). It can be distressing to learn that your bones are not as strong as they could or should be, however this could be your chance to stop bone loss. What you learn and do about bone health now is the key to building up your bones to prevent future fractures or broken bones. The disease is often called the silent thief because there are no symptoms of bone loss until the first break (fracture) happens.

Fragility Fracture

• A fracture resulting from a fall from standing height or less - WHO* 1999
• Patients who sustain a first fracture have a five-fold chance for future fractures despite the cause
• Identification of fragility fractures of the wrist, spine, proximal humerus and hip is the first step to treatment
• After you have had one fracture you are up to five times more likely to have another broken bone than someone who has never had a broken bone or fracture. This is new information learned in osteoporosis research. 
• Even if your bone density measurement is normal you need to be concerned about bone health if you have broken a bone with minimal trauma like after a fall from standing height or lifting a bag of groceries because bones can be brittle and need treatment even when bone density is near normal
• The interval between the first break (like your wrist) and a hip fracture can be up to 25 years
• Hip fractures are the most personally devastating break and more than 1 in 5 people who have a hip fracture will die in the first year after the hip fracture. For those who survive a hip fracture, more than 1 in 4 (25%) require some long-term nursing care and lose some mobility and independence.
• A survey of women over 75 showed that 80% would rather be dead than experience the loss of independence and quality of life that results from a hip fracture that leads to admission to long term care
• Osteoporosis is the presumed cause of 24,000 hip fractures in Canada each year
• Falls account for 86% of admissions to Ontario hospitals for people age 65 and older
• Hip fractures are the most common injury from falls in the elderly
• The first fall can create a cycle that leads to other falls unless the cycle is broken. What that means is that a first fall may increase the fear of falling again which leads to decreased activity and a loss of strength and mobility which in turn increases the risk of falling.

Health System Impacts

• Hip fracture is one of the most costly events for the health care system
• Costs associated with hip fractures totaled $650 million in Ontario in 2000, this figure is expected to rise to $2.4 billion by 2041.
• Projected that all active hospital beds will be occupied by hip fracture patients by 2041
• Over 90% of hip fractures are caused by osteoporosis.
• The death rate for men (30%) after hip fracture is higher than in women (20%)
• Osteoporosis is the most common bone condition in North America present in about 25% of all women after menopause and in 13% of men over 50

Good News

• Fractures are a complication of osteoporosis (thin bones) and not the inevitable and expected result
• It is never too late to build up your bone strength and prevent future fractures
• There are medicines available to treat and strengthen your bones that have few side effects and prevent half of all fractures!

*WHO = World Health Organization