Fragility Fracture Patients

A fragility fracture is defined as a break that occurs from a fall at standing height or less, indicating poor bone health. The most common fragility fractures occur at the hip, spine, humerus, pelvis, and wrist, although any low-trauma fracture is considered a fragility fracture, except those of the toes, fingers, and skull.

Half of hip fracture patients break another bone before their hip fracture, giving us an advance warning. Collaboration between Fracture Liaison Services (FLS) and primary care teams is key to acting early, implementing treatment recommendations, and preventing future fractures.

Osteoporosis New Zealand estimates that 22,300 fragility fractures occur annually among New Zealanders aged 50 years and over, including nearly 3,900 hip fractures and 2,900 symptomatic spine fractures.

Research shows that having any previous fragility fracture doubles the risk of future fractures. Up to half of individuals who sustain hip fractures have a history of previous fractures that occurred before the hip injury.

It is essential that people with fragility fractures are identified, investigated and offered osteoporosis-specific medication to prevent future fragility fractures. A number of highly effective, safe, and inexpensive medications have been shown to reduce future fracture risk by 30% to 70%, dependent on the agent used and site of fracture. Effective use of evidence-based falls interventions will add benefit above and beyond that delivered by osteoporosis treatment.

A nationwide network of Fracture Liaison Services (FLS) has been established to ensure that when people aged 50 years and over present to urgent care services – be that a hospital Emergency Department or a community based Walk In Accident and Medical Clinic (A&M) – that appropriate investigations are undertaken, interventions recommended and a long-term care plan is developed by the FLS in collaboration with the patient’s general practitioner.

A comprehensive longitudinal analysis of secondary fracture rates in individuals aged 50 years and older in New South Wales, Australia, was published in 2022. Applying these findings to the New Zealand population, it is estimated that, without a national systematic approach to secondary fracture prevention, the next decade could see around 182,000 secondary fracture-related hospital admissions and emergency department presentations, along with 354,000 outpatient attendances, costing approximately NZ$1.5 billion.

These findings highlight the urgent need for effective secondary fracture prevention and management strategies in New Zealand.