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World J Orthop. 2016 Mar 18;7(3):171-81. doi: 10.5312/wjo.v7.i3.171. eCollection 2016 Mar 18.

Major osteoporotic fragility fractures: Risk factor updates and societal impact.

World journal of orthopedics

Paola Pisani, Maria Daniela Renna, Francesco Conversano, Ernesto Casciaro, Marco Di Paola, Eugenio Quarta, Maurizio Muratore, Sergio Casciaro

Affiliations

  1. Paola Pisani, Maria Daniela Renna, Francesco Conversano, Ernesto Casciaro, Marco Di Paola, Sergio Casciaro, National Council of Research, Institute of Clinical Physiology, 73100 Lecce, Italy.

PMID: 27004165 PMCID: PMC4794536 DOI: 10.5312/wjo.v7.i3.171

Abstract

Osteoporosis is a silent disease without any evidence of disease until a fracture occurs. Approximately 200 million people in the world are affected by osteoporosis and 8.9 million fractures occur each year worldwide. Fractures of the hip are a major public health burden, by means of both social cost and health condition of the elderly because these fractures are one of the main causes of morbidity, impairment, decreased quality of life and mortality in women and men. The aim of this review is to analyze the most important factors related to the enormous impact of osteoporotic fractures on population. Among the most common risk factors, low body mass index; history of fragility fracture, environmental risk, early menopause, smoking, lack of vitamin D, endocrine disorders (for example insulin-dependent diabetes mellitus), use of glucocorticoids, excessive alcohol intake, immobility and others represented the main clinical risk factors associated with augmented risk of fragility fracture. The increasing trend of osteoporosis is accompanied by an underutilization of the available preventive strategies and only a small number of patients at high fracture risk are recognized and successively referred for therapy. This report provides analytic evidences to assess the best practices in osteoporosis management and indications for the adoption of a correct healthcare strategy to significantly reduce the osteoporosis burden. Early diagnosis is the key to resize the impact of osteoporosis on healthcare system. In this context, attention must be focused on the identification of high fracture risk among osteoporotic patients. It is necessary to increase national awareness campaigns across countries in order to reduce the osteoporotic fractures incidence.

Keywords: Fracture prevention; Fracture risk; Fragility fracture; Hip fracture; Osteoporosis

References

  1. Osteoporos Int. 2014 Oct;25(10):2359-81 - PubMed
  2. Osteoporos Int. 1992 Nov;2(6):298-302 - PubMed
  3. Osteoporos Int. 2011 Oct;22(10):2575-86 - PubMed
  4. Endocr Rev. 2001 Aug;22(4):477-501 - PubMed
  5. Osteoporos Int. 1997;7(4):390-406 - PubMed
  6. Radiol Clin North Am. 2010 May;48(3):497-518 - PubMed
  7. J Bone Miner Res. 2002 Jul;17(7):1237-44 - PubMed
  8. Osteoporos Int. 2013 Jan;24(1):23-57 - PubMed
  9. Lancet. 1999 Mar 13;353(9156):878-82 - PubMed
  10. J Bone Miner Res. 1993 May;8(5):575-82 - PubMed
  11. J Bone Miner Res. 1991 Jun;6(6):561-7 - PubMed
  12. J Bone Miner Res. 1996 Jul;11(7):984-96 - PubMed
  13. Radiol Clin North Am. 2008 Jul;46(4):735-54, vi - PubMed
  14. Reumatismo. 2014 Jul 28;66(2):136-43 - PubMed
  15. Osteoporos Int. 1997;7(5):414-25 - PubMed
  16. Bone. 2004 Nov;35(5):1029-37 - PubMed
  17. Calcif Tissue Int. 2004 Aug;75(2):90-9 - PubMed
  18. Radiographics. 2011 Sep-Oct;31(5):1343-64 - PubMed
  19. Osteoporos Int. 2006;17(5):637-50 - PubMed
  20. J Epidemiol Community Health. 2002 Jun;56(6):466-70 - PubMed
  21. Can J Surg. 1996 Apr;39(2):105-11 - PubMed
  22. J Bone Miner Res. 2000 Dec;15(12):2309-14 - PubMed
  23. J Clin Epidemiol. 1994 Mar;47(3):231-9 - PubMed
  24. N Engl J Med. 1990 Nov 1;323(18):1221-7 - PubMed
  25. Lancet. 2002 May 18;359(9319):1761-7 - PubMed
  26. J Bone Miner Res. 2003 Nov;18(11):1947-54 - PubMed
  27. Osteoporos Int. 2005 Nov;16(11):1330-8 - PubMed
  28. Int Orthop. 2007 Oct;31(5):665-9 - PubMed
  29. Clin Orthop Relat Res. 1996 Feb;(323):65-74 - PubMed
  30. Osteoporos Int. 1992 Nov;2(6):285-9 - PubMed
  31. Med Clin (Barc). 2001 Jan 27;116(3):86-8 - PubMed
  32. Osteoporos Int. 2005 Dec;16(12):2025-30 - PubMed
  33. Bone. 1999 Feb;24(2):151-5 - PubMed
  34. Eur J Radiol. 2009 Sep;71(3):388-91 - PubMed
  35. Pharm Res. 2009 Oct;26(10):2358-66 - PubMed
  36. Osteoporos Int. 2005 Jun;16(6):581-9 - PubMed
  37. Osteoporos Int. 2007 Jan;18(1):77-84 - PubMed
  38. Osteoporos Int. 2002;13(2):113-8 - PubMed
  39. Osteoporos Int. 1997;7(3):175-89 - PubMed
  40. Maturitas. 2013 Apr;74(4):341-5 - PubMed
  41. Ann Intern Med. 1987 Mar;106(3):354-61 - PubMed
  42. Osteoporos Int. 2003 Jun;14(4):301-5 - PubMed
  43. World Health Organ Tech Rep Ser. 1994;843:1-129 - PubMed
  44. Semin Musculoskelet Radiol. 2002 Sep;6(3):219-27 - PubMed
  45. J Bone Miner Res. 1995 Mar;10 (3):368-73 - PubMed
  46. BMJ. 1990 Oct 6;301(6755):790-3 - PubMed
  47. Osteoporos Int. 2011 May;22(5):1277-88 - PubMed
  48. Osteoporos Int. 2006 Dec;17(12):1726-33 - PubMed
  49. Osteoporos Int. 2002 Oct;13(10):777-87 - PubMed
  50. Endocrinology. 1999 Sep;140(9):4367-70 - PubMed
  51. Bone. 2007 Jun;40(6):1602-9 - PubMed
  52. Osteoporos Int. 2005 Dec;16(12):1963-8 - PubMed
  53. Osteoporos Int. 2004 Aug;15(8):625-32 - PubMed
  54. Bone. 1998 Feb;22(2):175-8 - PubMed
  55. Am J Med. 1983 Dec;75(6):977-83 - PubMed
  56. J Epidemiol Community Health. 1997 Aug;51(4):424-9 - PubMed
  57. J Bone Miner Res. 2004 Jun;19(6):893-9 - PubMed
  58. JAMA. 1990 May 2;263(17):2335-40 - PubMed
  59. Osteoporos Int. 2002 Jul;13(7):527-36 - PubMed
  60. Am J Epidemiol. 1984 Jan;119(1):9-22 - PubMed
  61. Osteoporos Int. 2007 Aug;18(8):1033-46 - PubMed
  62. Med J Aust. 2002 Apr 15;176 Suppl:S1-16 - PubMed
  63. Hard Tissue. 2013 Feb 15;2(1):7 - PubMed
  64. Proc Soc Exp Biol Med. 1989 Jul;191(3):261-71 - PubMed
  65. N Engl J Med. 1986 Jun 26;314(26):1676-86 - PubMed
  66. Endocrinology. 2001 Jun;142(6):2205-12 - PubMed
  67. Ultrasound Med Biol. 2015 Jan;41(1):281-300 - PubMed
  68. Nutr Rev. 1989 Mar;47(3):85-6 - PubMed
  69. J Bone Miner Res. 2005 Jul;20(7):1185-94 - PubMed
  70. Osteoporos Int. 1997;7(5):407-13 - PubMed
  71. Osteoporos Int. 1994 Jul;4(4):226-9 - PubMed
  72. Radiol Clin North Am. 2010 May;48(3):531-40 - PubMed
  73. Acta Orthop Scand. 1999 Feb;70(1):19-22 - PubMed
  74. Osteoporos Int. 2000;11(8):680-7 - PubMed
  75. Clin Epidemiol. 2015 Jan 09;7:65-76 - PubMed
  76. J Clin Endocrinol Metab. 1998 Jul;83(7):2266-74 - PubMed
  77. Osteoporos Int. 2001;12(8):623-9 - PubMed
  78. J Bone Miner Res. 1996 Jul;11(7):1019-25 - PubMed
  79. Lancet. 2004 Jan 17;363(9404):197-202 - PubMed
  80. Ann Intern Med. 1991 Dec 1;115(11):837-42 - PubMed
  81. Osteoporos Int. 2009 Jun;20(6):853-68 - PubMed
  82. Osteoporos Int. 2008 Apr;19(4):437-47 - PubMed
  83. Osteoporos Int. 2005 Feb;16(2):134-41 - PubMed
  84. J Bone Miner Res. 2000 Apr;15(4):721-39 - PubMed
  85. J Bone Miner Res. 1997 Jan;12(1):16-23 - PubMed
  86. Bone. 2002 Jan;30(1):251-8 - PubMed
  87. Osteoporos Int. 2005 Jun;16(6):597-602 - PubMed
  88. Arch Osteoporos. 2011;6:59-155 - PubMed
  89. J Bone Miner Res. 1992 Apr;7(4):449-56 - PubMed
  90. Joint Bone Spine. 2006 Mar;73(2):125-8 - PubMed

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