Feature Article

Secondary fracture prevention. Ensuring the first fracture is the last

Feature Article

Secondary fracture prevention. Ensuring the first fracture is the last

Kirtan Ganda, Markus J. Seibel

Figures

© ARTEM/stock.adobe.com
© ARTEM/stock.adobe.com

Abstract

Anyone who has suffered a minimal trauma fracture is at heightened risk of future fractures and the associated morbidity and mortality. Safe and effective pharmacological and nonpharmacological approaches are available to reduce the risk of recurrent fractures. It is critical that patients with incident fragility fractures are identified and managed early to make the first fracture the last.

Key Points

  • Sustaining a minimal trauma fracture (MTF) increases the risk of further fractures by at least twofold.
  • Assessment of clinical risk factors for osteoporosis is mandatory in every patient who presents with MTF.
  • Investigations include a bone mineral density scan and blood tests (e.g. vitamin D level).
  • Secondary causes of osteoporosis should be considered in all patients.
  • Safe and effective pharmacological and nonpharmacological treatments are available to prevent fractures; however, despite their wide availability a large treatment gap remains.
  • Systematic, co-ordinated approaches to secondary fracture prevention have been shown to improve treatment initiation rates and prevent further fractures.