Secondary Fracture Prevention

Abstract

AbstractFragility fractures signal that osteoporosis or osteopenia may be present. These are fractures often sustained through minimal trauma and commonly happen because of a fall from standing height or less. Low bone density due to osteoporosis or osteopenia means that such falls easily result in fractures. Fragility fractures are common, and the incidence is increasing despite global efforts to improve access to secondary prevention. Fragility fractures can lead to hospitalisation, increased risk of death due to complications, worsening chronic health conditions, and frailty. Hip and vertebral fractures are associated with the worst morbidity, mortality, and loss of functional ability. Pain and disability contribute to impaired quality of life.All people aged 50 years and over who sustain fragility fractures should, therefore, undergo investigation for osteoporosis and, if confirmed, be commenced on osteoporosis medication and be supported to participate in behaviours that are known to improve bone health. Organised and coordinated secondary fragility fracture prevention is the best option to prevent further fractures. This approach requires a multidisciplinary team working across care sectors in collaboration with the patient and family to ensure that care is consistent and person-centred and addresses individual need.Many communities across the globe who sustain fragility fractures, however, do not have access to diagnosis and evidence-informed treatment to prevent the next fracture despite strong evidence that access to treatment and supportive follow-up prevent many subsequent fractures. This chapter aims to explore how secondary fractures can be prevented through evidence-based interventions and services.