Traumatic fractures linked to osteoporosis

“Fractures previously defined as due to high trauma, such as those from a blunt injury in a motor vehicle crash or a fall from a chair, can no longer be dismissed as being unrelated to osteoporosis,” writes the author of an editorial accompanying new research on the subject.

The investigation revealed that high-trauma fractures in older individuals are associated with low bone mineral density and increase the risk of subsequent fractures, while a new clinical algorithm can help predict the 5-year risk of hip fracture in postmenopausal women. These research findings are published in two studies in the Nov. 28 issue of the Journal of the American Medical Association.

In the first study, Dawn C. Mackey and colleagues at the San Francisco Coordinating Center, California Pacific Medical Center Research Institute, analyzed data from 14,017 older US adults to investigate the link between bone mineral density (measured by dual-energy x-ray absorptiometry) and risk of high-trauma fractures. The researchers found that high-trauma fractures were associated with low bone mineral density, and individuals sustaining high-trauma fractures were at an increased risk of subsequent high-trauma and low-trauma fractures.

In the second study, John Robbins, MD, of the University of California at Davis in Sacramento, and colleagues analyzed data from 93,676 postmenopausal women to create a model predicting 5-year risk of hip fracture, and then tested the model in 10,750 women with bone mass density measurements. Eleven factors predicted hip fracture within

5 years: age, self-reported health, physical activity, weight, height, race/ethnicity, history of fracture after age 54, parental hip fracture, current smoking, corticosteroid use, and treated diabetes. Incorporation of these factors into an algorithm allowed the prediction of the 5-year risk of hip fracture across ethnicities.

Mackey DC, Lui LY, Cawthon PM, et al. High-trauma fractures and low bone mineral density in older women and men. JAMA. 2007;298:2381-2388.

Robbins J, Aragaki AK, Kooperberg C, et al. Factors associated with 5-year risk of hip fracture in postmenopausal women. JAMA. 2007;298:2389-2398.