Which factor increases the risk for multiple fractures in patients with osteoporosis?

Updated: Jan 20, 2021
  • Author: Rachel Elizabeth Whitaker Elam, MD, MSc; Chief Editor: Herbert S Diamond, MD  more...
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Patients who have sustained one osteoporotic fracture are at increased risk for developing additional osteoporotic fractures. [70] For example, the presence of at least one vertebral fracture results in a 5-fold increased risk of developing another vertebral fracture. One in 5 postmenopausal women with a new vertebral fracture incurs another vertebral fracture within one year. [92]

Patients with previous hip fracture have a two-fold [93] to 10-fold increased risk of sustaining a second hip fracture. In addition, patients with ankle, knee, olecranon, and lumbar spine fractures have a 1.5-, 3.5-, 4.1-, and 4.8-fold increased risk of subsequent hip fracture, respectively. Site of prior fracture impacts on future risk of osteoporotic fractures independent of BMD such that in postmenopausal women, prior fractures of the spine, humerus, patella, and pelvis are more predictive of future osteoporotic fractures than fractures at other sites. [94]

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