Introduction to osteoporosis and minimal-trauma fracture

Osteoporosis is characterised by low bone mineral density (BMD) and microarchitectural deterioration of bone tissue, leading to bone fragility and increased fracture risk. Together with falls and older age, osteoporosis is an important risk factor for minimal-trauma fracture (a fracture resulting from trauma no greater than a fall from a standing height).

Common sites of minimal-trauma fracture include the vertebral bodies, distal radius, proximal humerus, pelvis and proximal femur. Fractures of the fingers, toes, face and skull are usually not related to osteoporosis.

Minimal-trauma fractures remain a major cause of morbidity in Australia, and mortality is increased after minimal-trauma fractures in adults older than 60 years. Prevention of fractures is important; fractures cause pain and disability to the patient, and have a high health economic burden.

Although many effective treatments for osteoporosis are available, fewer than 20% of patients who present with a minimal-trauma fracture are investigated for osteoporosis or treated to prevent secondary fracture. Consider osteoporosis in any patient older than 50 years who sustains a minimal-trauma fracture. For assessment of bone status, see here. The decision to start osteoporosis treatment is based on multiple factors, including fracture site, BMD and the presence of other risk factors for fracture (see Considerations before treating osteoporosis, Management of osteoporosis following minimal-trauma fracture and Management of osteoporosis in the absence of fracture for treatment decisions).

For information about osteoporosis during pregnancy and breastfeeding, see here. For information about osteoporosis and bone health in children, see here.