Understanding Fragility Fractures

Everyone is aware of what fractures are – a complete break or a crack in the bones of the body usually sustained due to a bad fall, while playing high-impact sports or when involved in a road traffic accident. But what is a fragility fracture?

A fragility fracture is when the break occurs due to very low impact activity. This kind of activity will in normal circumstances not lead to a fracture. A fragility fracture happens because the bones are weak. The joints usually affected by a fragility fracture include:

• Hip
• Wrist
• Spine

Causes of Fragility Fractures

Osteoporosis – most fragility fractures are because of this condition.

Other causes include:

• A cyst in the bone
• Cancer
• Osteomyelitis
• Genetic bone diseases

Consequences of Fragility Fractures

• Other than being quite painful, fragility fractures can incapacitate patients.
• This will affect the patient’s mental well-being – they lose their independence and dignity.
• The quality of life is reduced and the patient might need a caretaker to be present at all times.
• Fracture treatments have significant financial repercussions.

Read More: Paget’s Disease: Causes, Symptoms and Treatment

Risk Factors

• Age: The risk of fracture increases after the age of 50.
• Gender: Women are more susceptible than men.
• Heredity: A close family member having osteoporosis increases the risk.
• A History of Previous Fractures: If a fragility fracture has been sustained once, the possibility of another one is greater.
• Menopause: Women after menopause are at a higher risk.
• Rheumatoid Arthritis: This is an autoimmune disease that increases the risk of osteoporosis.
• Certain medications weaken the bones and so increase the risk of osteoporosis.

These risk factors are fixed – we cannot do anything to alter them but being aware can help us stay alert and take the necessary steps to avoid fragility fractures.

Certain other risk factors are modifiable. They include the following:

• Alcohol: Increased alcohol intake escalates fracture risk by 40%.
• Smoking: Chronic smokers have an increased risk of fractures.
• BMI (Body Mass Index) Lower Than Normal: Individuals who are underweight double their fracture risk when compared to people with normal weight.
• Diet: A nutritious diet is extremely important in the absence of which the risk of both osteoporosis and fractures increase.
• Inactivity: This doubles the risk of a hip fracture and so following an active lifestyle is advised.
• Reduced intake of calcium and vitamin D: Deficiencies of both will increase fracture risk – eating food rich in vitamin D, exposure to sun and calcium supplements will help.

Treatment Options for Osteoporosis

Osteoporosis does not present any symptoms – it is a silent condition and, in most cases, it is diagnosed only after a fracture occurs In some cases it may remain undiagnosed even after a fracture.

Treatment options involve a combination of the following:

• Medication: Most patients are treated with bisphosphonates which work by minimizing bone loss.
• Calcium and Vitamin D Supplements: This is extremely important especially for post-menopausal women to increase their bone strength.
• Lifestyle Modification: Quitting alcohol and smoking, eating a well-balanced diet and staying active will not only reduce the risk of osteoporosis but will guard against many other diseases as well.
• Learning and following fall prevention measures.

Sometimes, despite our efforts, falls do happen resulting in fragility fractures. Given below is some information about the most common fragility fractures which are of the spine, hip and wrist fractures.

Spinal Fractures

• When the vertebrae in the spinal cord suffer a break, it is called a spinal fracture.
• When your bones are already weak due to osteoporosis, even something as simple as bending down to pick up an object can result in a fracture.
• The treatment depends on the severity of the fracture.
• A small fracture might not require any treatment and might even mend on its own.
• A stooped posture can be a symptom of a spinal compression fracture.
• Pain in the middle of the lower back is common; this pain will increase with activity and there might be some relief while lying down.
• A painful fracture requires an immediate consultation with an orthopedic doctorwho will advise you on the treatment options.

Hip Fractures

• Symptoms of a fragility fracture to the hip include inflammation, hip pain and difficulty walking.
• Sometimes one leg appears shorter than the other.
• People usually find the condition too painful to walk.
• There are chances of surgical intervention as the priority is to get the patient mobile again.

Wrist Fractures

• Typically sustained when a person lands on his hand while falling. Wrist fractures can often be the precursor for other types of fractures. Their importance should not be underplayed.
• Symptoms include:
• Pain at the wrist
• The wrist appears swollen and sometimes disfigured
• Holding objects in the injured hand is painful
• Diagnosis involves a physical examination and imaging tests.
• Treatment depends on the severity of the fracture.
• Options include casts or surgery followed by rehabilitation.

A Few Important Points to Note

• It is important to stay on guard and identify patients who are at risk of osteoporosis.
• Awareness plays a crucial role and therefore educating people is important. Armed with the right information, they can then make the required lifestyle modifications to reduce the risk of osteoporosis and fragility fractures.
• Patients need support to cope with their condition when diagnosed with osteoporosis after a fall.
• Sometimes the fear of falling again is so much that they might even be unwilling to walk.
• With mobility impaired, the feeling of dependency on others might lead to depression.
• However, people diagnosed with osteoporosis can lead normal lives. There are numerous options for pain management which include medication, exercises, cold/warm compress, etc.
• Techniques to relax help immensely as well.
• When diagnosed with osteoporosis, many people do not realize the social and emotional ramifications.
• Remember, help is always at hand so do not hesitate to reach out. With support and treatment, a good quality of life is definitely possible.