Osteoporosis, Fragility Fractures & Falls
Use a low-trauma fracture as an opportunity for bone-health and falls prevention.
Quick revision ↓ Medical Dictionary
01Recognise fragility
A fracture after a low-energy event can indicate reduced bone strength. Ask about previous fractures, glucocorticoids, smoking, nutrition and relevant diseases. Osteoporosis can be present before pain occurs, and a fracture should prompt assessment beyond repairing the immediate injury.
02Assess risk
Use an appropriate validated risk tool and bone-density testing according to age, sex and local guidance. Risk tools have defined populations and limitations; do not apply an older-adult algorithm automatically to a child or young adult. Consider secondary causes and investigate when indicated.
03Vertebral fractures
New back pain, height loss or kyphosis in a person at risk may indicate a vertebral fracture. Some are initially unrecognised. Assess neurological findings and alternative serious causes, arrange appropriate imaging, and address pain and mobility alongside prevention of further fractures.
04Prevention and treatment
Support suitable exercise, adequate nutrition, smoking cessation and correction of deficiencies where indicated. Medication decisions depend on fracture risk, organ function and the specific drug. Explain administration and review needs; some therapies require a planned transition when stopped rather than abrupt unsupervised cessation.
05Falls and continuity
Review balance, vision, medicines, footwear and environmental hazards as relevant. A fracture-liaison or equivalent service can coordinate secondary prevention. Agree follow-up and adherence support; a discharge prescription without monitoring or access to care is not a complete prevention strategy.
High-Yield Revision
- A fragility fracture is a prevention opportunity.
- Risk tools have population limits.
- Bone-health treatment needs continuity and review.
Common Pitfalls
- Treating the fracture without addressing future risk.
- Stopping long-term bone treatment without a drug-specific plan.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.