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Secondary prevention of osteoporosis: when should a non-vertebral fracture be a trigger for action?

Secondary prevention of osteoporosis: when should a non-vertebral fracture be a trigger for action?
Secondary prevention of osteoporosis: when should a non-vertebral fracture be a trigger for action?
The burden of non-vertebral fractures is enormous. Hip fractures account for nearly 10% of all fractures (and a much greater proportion in the elderly), while wrist fractures may account for up to 23% of all limb fractures. The best available predictors of non-vertebral fracture risk are low BMD and a tendency to fall. Hip, forearm, proximal humerus and rib fractures have all been associated with low BMD, though ankle fracture is not strongly related to osteoporosis. Although clinical risk factors identify only about one-third of postmenopausal women at increased risk of osteoporotic fracture, the occurrence of one fracture commonly predicts a second fracture. Guidelines are presented for identifying and treating patients at risk of non-vertebral osteoporotic fractures, especially those with a previous fracture, based on the algorithm recently published by the Royal College of Physicians and the Bone and Tooth Society. Prevention of falls and use of external hip protectors may reduce the occurrence of hip fracture. Treatment options for patients presenting with hip fracture include HRT, bisphosphonates, and calcium plus vitamin D, and for Colles' fracture include general measures, HRT, bisphosphonates, or calcitonin plus calcium.
1460-2725
575-597
Eastell, R.
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Reid, D.M.
80c8f859-f13a-4129-b884-c0fbc46d61b8
Compston, J.
b64c0d0e-97dd-44c8-97ba-f756f0bc966d
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Fogelman, I.
76f47133-7155-4dc6-8165-7b75b7ebeddd
Francis, R.M.
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Hay, S.M.
6926c92e-19f4-4b2f-8db6-4ecd1a82ddf6
Hosking, D.J.
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Purdie, D.W.
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Ralston, S.H.
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Reeve, J.
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Russell, R.G.
56578353-52d3-4bb5-9063-a915e86e95c8
Stevenson, J.C.
d504af4e-3bbd-4f9b-81ee-d34d50c29554
Eastell, R.
1650872d-d27d-4543-a112-d6008810fa25
Reid, D.M.
80c8f859-f13a-4129-b884-c0fbc46d61b8
Compston, J.
b64c0d0e-97dd-44c8-97ba-f756f0bc966d
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Fogelman, I.
76f47133-7155-4dc6-8165-7b75b7ebeddd
Francis, R.M.
24c83ccf-43d2-4a8d-b3db-7ef2ea0241f7
Hay, S.M.
6926c92e-19f4-4b2f-8db6-4ecd1a82ddf6
Hosking, D.J.
085ebfde-049f-4747-9fe6-43aa7969846f
Purdie, D.W.
61d63167-2430-470e-bfb3-484125e26c80
Ralston, S.H.
50a169e7-7b4c-471c-be24-61c8af915f17
Reeve, J.
8f5bc093-0e10-42ca-8d4a-07c1eaace565
Russell, R.G.
56578353-52d3-4bb5-9063-a915e86e95c8
Stevenson, J.C.
d504af4e-3bbd-4f9b-81ee-d34d50c29554

Eastell, R., Reid, D.M., Compston, J., Cooper, C., Fogelman, I., Francis, R.M., Hay, S.M., Hosking, D.J., Purdie, D.W., Ralston, S.H., Reeve, J., Russell, R.G. and Stevenson, J.C. (2001) Secondary prevention of osteoporosis: when should a non-vertebral fracture be a trigger for action? QJM: An International Journal of Medicine, 94 (11), 575-597.

Record type: Article

Abstract

The burden of non-vertebral fractures is enormous. Hip fractures account for nearly 10% of all fractures (and a much greater proportion in the elderly), while wrist fractures may account for up to 23% of all limb fractures. The best available predictors of non-vertebral fracture risk are low BMD and a tendency to fall. Hip, forearm, proximal humerus and rib fractures have all been associated with low BMD, though ankle fracture is not strongly related to osteoporosis. Although clinical risk factors identify only about one-third of postmenopausal women at increased risk of osteoporotic fracture, the occurrence of one fracture commonly predicts a second fracture. Guidelines are presented for identifying and treating patients at risk of non-vertebral osteoporotic fractures, especially those with a previous fracture, based on the algorithm recently published by the Royal College of Physicians and the Bone and Tooth Society. Prevention of falls and use of external hip protectors may reduce the occurrence of hip fracture. Treatment options for patients presenting with hip fracture include HRT, bisphosphonates, and calcium plus vitamin D, and for Colles' fracture include general measures, HRT, bisphosphonates, or calcitonin plus calcium.

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Published date: 2001

Identifiers

Local EPrints ID: 25423
URI: https://eprints.soton.ac.uk/id/eprint/25423
ISSN: 1460-2725
PURE UUID: 78cc5062-495e-404d-8d7b-7e5359d7d810
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 07 Apr 2006
Last modified: 06 Jun 2018 12:59

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Contributors

Author: R. Eastell
Author: D.M. Reid
Author: J. Compston
Author: C. Cooper ORCID iD
Author: I. Fogelman
Author: R.M. Francis
Author: S.M. Hay
Author: D.J. Hosking
Author: D.W. Purdie
Author: S.H. Ralston
Author: J. Reeve
Author: R.G. Russell
Author: J.C. Stevenson

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