Breaking Point First Fracture May Be a Warning Sign of Osteopororis
A fracture can be more than a just a broken bone. It may be a warning sign that you have osteoporosis.
Osteoporosis is a medical condition that weakens bone by making it more porous and less dense. Bone density is one of the factors that determine bone strength, so individuals with low bone density have a higher risk for fracture and refracture.
Osteoporosis is a contributing factor in as many as 1.5 million fractures each year, including about 300,000 hip fractures, about 700,000 vertebral (spine) fractures, about 250,000 wrist fractures, and about 300,000 fractures at other sites.
The risk of a serious fracture can double after a first fracture in certain high-risk groups. Additionally, many patients, particularly those who suffer hip fractures, are at high risk for premature death or loss of independence after the fracture.
Consider that one out of four people who have an osteoporotic hip fracture will need long-term nursing home care, half of those who experience osteoporotic hip fractures are unable to walk without assistance, and those who experience the trauma of an osteoporotic hip fracture have a 24{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} increased risk of dying within one year following the fracture. Clearly, identifying osteoporosis early and initiating treatment is essential.
Who Should Be Concerned?
Recent data indicates that osteoporosis occurs in all racial groups. Hispanic women may be among those at highest risk. Between 13{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} and 16{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of Hispanic women have osteoporosis. And as many as 49{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of Mexican-American women 50 years of age or older have low bone density.
Although the rate of hip fractures is lower in Asian-American women, the rate of vertebral fractures is about equal between Asian-American and Caucasian women.
About 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of African-American women over 50 have osteoporosis. An additional 30{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} have low bone density. Between 80{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} and 95{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of all fractures experienced by African-American women over age 64 are related to osteoporosis.
Men should also be concerned about osteoporosis. Approximately one in eight men will have an osteoporotic fracture. Men with a history of hypogonadism, thyroid dysfunction, long-term steroid therapy, high alcohol consumption, or low physical activity are especially at risk. One-third of all hip fractures experienced by men are related to osteoporosis, and one-third of these men will die within the first year after the fracture.
A fracture in adulthood does not always mean an individual has osteoporosis. However, every adult who suffers a fracture should discuss the need for bone-density testing with a physician. If your bone density is low, you may need additional medical tests. Medical conditions other than osteoporosis can cause low bone density.
What Can Be Done?
There is no specific cure for osteoporosis. However, if you have been diagnosed with it, diet and lifestyle changes can reduce your risk of refracture. You should also discuss medical therapy with your physician.
People at risk, and even individuals without osteoporosis, should follow these four simple guidelines:
• Make sure you get enough calcium and Vitamin D in your diet. The National Academy of Sciences recommends 400 to 800 units of Vitamin D and 1,000 to 1,500 mg of calcium per day.
• Participate in activities that will strengthen bone and muscle. Regular exercise is one of the best things you can do to prevent osteoporosis. Weight-bearing exercises like walking, jogging, and tennis, as well as low-impact exercise classes, are best for building and maintaining strong bones.
• Because falls are the most common cause of fractures, do some balance activities to reduce your risk. The benefits of tai chi in particular have been well-documented; tai chi decreases falls among older individuals by 47{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}.
• If you have had a broken bone, talk to your doctor about a bone-density test. You may also wish to discuss other steps you can take to reduce the risk of a second fracture. v
This article was prepared by the American Academy of Orthopedic Surgeons.
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