Skip to main content
Log in

Fracture risk following an osteoporotic fracture

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

The aim of this study was to examine the pattern of fracture risk following a prior fracture at the spine, shoulder or hip. We studied 1918 patients with fractures at these sites identified from the Department of Radiology in Malmo who were followed for 5 years. Poisson regression was used to compute fracture rates immediately after the initial fracture and at 5 years thereafter in men and women aged 60 or 80 years. Immediate fracture risk was higher than that of the general population, more markedly so at the age of 60 than at 80 years. At the age of 60 years, the risk of hip, forearm and spine fractures were significantly increased following a prior spine, hip or shoulder fracture in men. A similar pattern was seen in women, except that the increase in risk of forearm fracture following a spine or hip fracture was not statistically significant. The incidence of further fractures at the shoulder, spine or hip fell with time after the first fracture, a fall that was significant for all fractures after a shoulder fracture, hip fracture after a spine fracture, and hip and spine fractures after a hip fracture. We conclude that the risk of a subsequent fracture immediately after an osteoporotic fracture is highest immediately after the event. This provides a rationale for very early intervention immediately after fractures to avoid recurrent fractures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Klotzbuecher CM, Ross PD, Landsman PB, Abbot III TA, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721–739

    CAS  PubMed  Google Scholar 

  2. Johnell O, Odén A, Caulin F, Kanis JA (2001) Acute and long-term increase in fracture risk after hospitalization for vertebral fracture. Osteoporos Int 12:207–214

    Article  CAS  PubMed  Google Scholar 

  3. Lindsay R, Silverman SL, Cooper C, Hanley DA; Barton I, Broy SB, Licata A, Benhamou L, Geusens P, Flowers K, Stracke H, Seeman E (2001) Risk for new vertebral fracture in the year following a fracture. JAMA 285:320–323

    CAS  PubMed  Google Scholar 

  4. Kanis JA, Johnell O, Odén A, Sernbo I, Redlund-Johnell I, Dawson A, De Laet C, Jönsson B (2000) Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int 11:669–674

    Article  CAS  PubMed  Google Scholar 

  5. Jonsson B, Gardsell P, Johnell O, Redlund-Johnell I, Sernbo I (1994) Remembering fractures: fracture registration and proband recall in Southern Sweden. J Epidemiol Comm Health 48:489–490

    CAS  Google Scholar 

  6. Van Staa TP, Leufkens HGM, Coopewr C (2002) Does a fracture at one site predict later fractures at other sites? A British cohort study. Osteoporos Int 13:624–629

    Article  Google Scholar 

  7. Hasserius R, Karlsson MK, Nilsson BE, Redlund-Johnell I, Johnell O (2003) Prevalent vertebral deformities predict increased mortality and increased fracture rate in both men and women: a 10 year population-based study of 598 individuals from the Swedish cohort in the European Vertebral Osteoporosis Study. Osteoporos Int 14:61–68

    CAS  PubMed  Google Scholar 

  8. Castel H, Bonneth DY, Sherf M, Liel Y (2001) Awareness of osteoporosis and compliance with management guidelines in patients with newly diagnosed low impact fractures. Osteoporos Int 12:559–564

    Article  CAS  PubMed  Google Scholar 

  9. Torgerson DJ, Dolan P (1998) Prescribing by general practitioners after an osteoporotic fracture. Ann Rheum Dis 57:378–379

    CAS  PubMed  Google Scholar 

  10. Black DM, Cummings SR, Karpf DB et al. (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fracture. Lancet 348:1535–1541

    CAS  PubMed  Google Scholar 

  11. Cummings SR, Black DM, Thompson DE et al. (1998) Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures. JAMA 280:2077–2082

    CAS  PubMed  Google Scholar 

  12. Harris ST, Watts NB, Genant HK et al. for the VERT Study Group (1999)Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis. A randomized controlled trial. JAMA 282:1344–1352

    CAS  PubMed  Google Scholar 

  13. Reginster J-Y, Minne HW, Sörensen OH et al. (2000) on behalf of the VERT Study Group. Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Osteoporos Int 11:83–91

    CAS  PubMed  Google Scholar 

  14. McClung MR, Geusens P, Miller PD et al. (2001) for the Hip Intervention Program Study Group. Effect of risedronate on the risk of hip fracture in elderly women. N Engl J Med 344:333–340

    Article  CAS  PubMed  Google Scholar 

  15. Ettinger B, Black DM, Mitlak BH et al. (1999) Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene; results from a 3-year randomized clinical trail. Multiple Outcome of Raloxifene Evaluation (MORE) Investigators. JAMA 282:637–645

    CAS  PubMed  Google Scholar 

  16. Neer RM, Arnaud CD, Zanchetta JR et al. (2001) Effect of parathyroid hormone (1–34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 344:1434–1441

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We are grateful for the unrestricted support of the Alliance for Better Bone Health, Lilly, Hologic, IGEA, G-E Lunar, Wyeth, Roche and Novartis. These studies were supported by the International Osteoporosis Foundation, the National Osteoporosis Foundation and the International Society for Clinical Densitometry.

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Johnell, O., Kanis, J.A., Odén, A. et al. Fracture risk following an osteoporotic fracture. Osteoporos Int 15, 175–179 (2004). https://doi.org/10.1007/s00198-003-1514-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-003-1514-0

Keywords

Navigation