Health guide
Learn why a previous fracture may signal a need for further assessment and prevention.
Breaking a bone can be a painful and disruptive experience. After receiving treatment, it is natural to focus on healing and returning to everyday activities.
However, some fractures also provide important information about a person's underlying bone health.
A fracture that occurs after a relatively minor fall or other low-impact event may indicate that the bones have become fragile.
For some people, assessing and addressing the underlying risk is an important part of preventing another fracture.
Fractures occur for different reasons.
Some result from high-impact injuries, such as serious road-traffic collisions or falls from a considerable height.
Others occur after relatively minor trauma, such as falling from standing height.
A fracture following minor trauma may be considered a fragility fracture, particularly in an older adult.
Fragility fractures are important because they may reveal reduced bone strength. People who have experienced one such fracture can have an increased risk of further fractures.
Not every fracture indicates osteoporosis. The circumstances of the injury, age, medical history and other risk factors must be considered.
After a fracture, immediate treatment focuses on the injured bone and any associated injuries.
However, if the fracture occurred after minor trauma, further assessment may be appropriate.
Possible contributing factors include:
Identifying these factors can help guide prevention.
A healthcare professional may consider your age, fracture history, medical conditions, medicines and lifestyle.
Depending on the findings and the available services, assessment may include a bone-density scan or other investigations.
A bone-density test measures bone mineral density and can help diagnose osteoporosis.
However, a person's fracture risk is not determined by bone density alone. Previous fractures and other clinical factors are also important.
Ask your treating clinician whether the circumstances of your fracture suggest that further bone-health assessment is needed.
Adequate nutrition contributes to normal bone and muscle health.
Calcium, vitamin D, protein and other nutrients are important.
Try to maintain a varied diet that includes appropriate sources of calcium, protein, vegetables, fruits and other nutritious foods.
For Ethiopian households, suitable choices may include legumes, grains, vegetables, dairy products, eggs and other available protein sources.
The most suitable diet depends on individual needs, availability and any underlying medical conditions.
Supplements may be recommended when necessary, but they should not be treated as the only measure needed to prevent another fracture.
Physical activity can help maintain bone health, rebuild muscle strength and improve balance.
However, activity following a fracture must be appropriate for the type of injury, the treatment received and the stage of healing.
Follow the instructions of your treating healthcare professional regarding movement, weight-bearing and rehabilitation.
Do not begin demanding exercises or return to high-impact activity before it is appropriate for your injury.
Once it is safe to do so, a suitable programme may include weight-bearing activity, resistance exercises and balance training.
For people whose fractures resulted from falls, reducing the risk of another fall is especially important.
Consider factors such as:
Some people benefit from a professional fall-risk assessment and an individualized prevention plan.
Home improvements and appropriate walking aids may also help.
If osteoporosis or another underlying condition is diagnosed, treatment may help reduce future fracture risk.
For osteoporosis, a clinician may prescribe medication in addition to nutrition, exercise and fall-prevention measures.
Different medicines are appropriate for different people. Treatment depends on fracture risk, other medical conditions and clinical judgment.
Take prescribed medicines as directed, and discuss side effects or concerns with the prescribing clinician.
Do not discontinue treatment simply because you feel better or your original fracture has healed.
Follow-up after a fracture can help the treating team assess healing, address complications and determine when activities can safely resume.
Where bone fragility is suspected, follow-up should also address long-term fracture prevention.
Useful questions to discuss include:
During recovery, seek medical attention for new or worsening symptoms as instructed by your treating team.
Urgent assessment is needed if you experience a new suspected fracture, severe pain after another fall, a visible deformity or an inability to stand or walk.
New numbness, loss of circulation or other serious symptoms following an injury also require urgent assessment.
A second fracture should not be dismissed simply because a previous fracture has already been treated.
No. Fractures can result from many different injuries and medical conditions. However, a fracture after minor trauma may justify further bone-health assessment.
Calcium is important for bone health, but fracture risk depends on several factors. Some people need additional assessment, fall-prevention measures or prescription treatment.
That depends on your age, the circumstances of the fracture, your medical history and the assessment of your healthcare professional.
References for editorial review: NIAMS, Preventing Another Broken Bone; NIAMS, Osteoporosis; and CDC, Preventing Falls and Hip Fractures.
Evidence basis: NIAMS guidance on secondary fracture prevention, underlying bone-health assessment and treatment, supported by CDC guidance on fall prevention.
