Fragility Fracture Clinic

According to the National Osteoporosis Foundation, approximately one in two women and one in four men over age 50 will have an osteoporosis-related fracture. These fractures can dramatically change the quality of life for patients and their families due to a loss of patient independence, significant disability, and even death.

That’s why The University of Michigan established The Fragility Fracture Clinic. Our dedicated team provides comprehensive post-fracture bone health care - including diagnosis, treatment, therapy, education, and research for patients that have incurred a Fragility Fracture. The Clinic provides one on one assessments, coordinates lab, radiology, and pharmacy services, and offers specialized treatment—all with the goal and focus of promoting bone health, reducing fracture risks, accelerating healing, and preventing re-fractures.

A Fragility Fracture is any fall from a standing height or less that results in a fracture.  Our bodies should be able to sustain a fall from this height without a fracture unless there is an underlying cause that makes the bones fragile.  The most common areas involved include the hip, spine, and wrist. The first fracture is a warning sign! It should result in immediate screening and, if indicated, management and treatment for osteoporosis.

The Bone Health Clinic, staffed by Clare Masternak, PA, Karen Cummings, PA, and Jaimo Ahn, MD, personalized treatment recommendations based on individual bone density and laboratory testing as well as comprehensive medical evaluations. Our center participates in the American Orthopaedic Association’s Own the Bone® program, a clinically-proven quality improvement program that uses a multidisciplinary approach to ensure patients get the diagnoses and treatment necessary to prevent secondary fractures.

Facts Regarding Fragility Fractures

  • Osteoporosis has no signs or symptoms until a fracture occurs - this is why it is often called a "silent disease."
  • One-half of all women and up to one-quarter of all men will suffer a fragility fracture in their lifetime.

  • If you've had a previous fragility fracture, you are twice as likely to suffer a fracture in the future.
  • 5 to 10% of patients experience a recurrent hip fracture with about 3.3 years between the first and second fracture.
  • 80% of individuals who have already had at least one osteoporotic fracture are neither identified nor treated.
  • Fragility fractures have become nearly epidemic in the United States among older adults, with over 2 million fractures occurring each year - more than heart attacks, strokes, and breast cancer combined.

What does this mean for you?

  • Recognition and treatment of your fragility fracture can reduce the risk of future fractures by up to 50%
  • Treatment of your fragility fracture can stop the downward spiral in health and quality of life that often follows fractures.
  • Diagnosis and treatment following an initial fragility fracture reduce the burden of suffering and further health care costs.

Frequently Asked Questions

What is osteoporosis?  
Also known as porous bone, osteoporotic bone is spongy and full of holes.  This condition causes low bone mass and makes bone more fragile and likely to break.  Many people are unaware of the link between fractures and osteoporosis.  If you are over age 50, there is a very good chance that your fracture is related to osteoporosis.

What causes osteoporosis?   
Osteoporosis may occur for several reasons. Heredity plays a role, as does ethnicity.  It is more common among whites and Asians, though African-Americans and Hispanics may still be at risk.   If you did not build bone sufficiently during your bone-building years, you might be at risk as you age. Decreased levels of estrogen (in women) and testosterone (in men) may contribute to bone loss. Inadequate intake of calcium and vitamin D as a child, as an adult, or both may lead to osteoporosis. Some medications, although necessary, will cause bone depletion.

How do I know if I have osteoporosis? 
A bone mineral density test (DEXA) can detect osteoporosis. The test uses low dose x-ray to measure bone density in the hip and the spine.  The test takes less than 15 minutes.  The test compares your bone mineral density (BMD) with that of a healthy 30-year-old since that’s when bone mass is at its peak.  The results come as a T-score in these ranges: -1.0 and higher is normal bone density.  A score between -1.0 and -2.5 indicates low bone density (osteopenia).  A score of -2.5 or below indicates osteoporosis.  As your bone density decreases, your T-score gets lower.

What if I have osteopenia? 
If you have bone loss but not enough to be osteoporotic, you may have a condition called osteopenia.  Osteopenia can progress to osteoporosis, but with changes in diet and exercise and early treatment, you can slow the bone loss process.

What Can I Do to Help?

  • Alcohol in excess can lead to bone loss and risk of falls, so drink in moderation. On average, an alcohol intake of 3 or more drinks per day is detrimental to bone health.
  • Be a nonsmoker! Tobacco is toxic to your bone health and may interrupt healing if you’ve incurred a fracture.  Investigate programs, medications, and other stop-smoking methods.
  • Calcium is important, so eating calcium-rich foods can help protect your bones. Dairy products rich in calcium include milk, cheese, and yogurt.  Non-daily food options include broccoli, almonds, and sardines. Over-the-counter calcium supplements are also available.  Adult men and women need 1000 mg. of calcium daily.
  • D3 (Vitamin) is necessary for calcium absorption.  Sunshine and fortified foods like milk can help meet your daily quota. Despite this, supplementation is often necessary!  Your healthcare provider may want to obtain a vitamin D level blood test for you and treat you accordingly.
  • Exercise daily! Even modest increases in weight bearing can be helpful to keep bones and muscles strong. Walking, dancing, hiking, or tennis can make bones stronger and denser.
  • Fall prevention - If you are unsteady, Physical Therapy and/or an assistive device can prevent further fall risk.  To prevent a fall, minimize clutter, and be sure that your area rugs are anchored to the floor. Eliminate throw rugs and loose cords.  Wear sturdy, rubber-soled shoes.

The factors I can’t control:  
Women who are thin and have small frames, as well as those who experience early menopause (before age 45), are more likely to develop osteoporosis.  Some conditions, such as diabetes, rheumatoid arthritis, Crohn’s, or celiac disease, will put you at risk. A family history of osteoporosis and hip fracture will increase your risk. Often necessary medications such as long-term glucocorticoid therapy (Prednisone or Prednisolone) can affect your bone health.

Resource Links:

--> Own The Bone

--> National Osteoporosis Foundation 

--> International Osteoporosis Foundation

--> Academy of Women's Health Blog

--> University of Michigan Tobacco Consultation Service

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