Research updates
Osteoporosis   p 5
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2. What is osteoporosis? Link to the Medical Research Council web site
2.3 The clinical problem
Osteoporosis is a silent disease characterised by low bone density and micro-architectural deterioration of bone tissue. The clinical problem is that the bones become fragile and fractures occur. More than one-third of women suffer one or more osteoporotic fractures during their lifetime. The risk for men is lower but still substantial. Osteoporotic fractures have three distinctive features:
  • the incidence rate is greater among women than men;
  • incidence rates increase steeply with age;
  • osteoporosis usually affects the whole skeleton but it commonly causes fractures in the hip, spine or distal forearm. These are sites where there is a large proportion of trabecular bone.
Hip fracture
Hip fracture is the most severe osteoporotic fracture since patients invariably require admission to hospital. After a hip fracture, up to 40% of people are unable to walk unaided and some require long term care in institutions. 90% of the total burden on National Health Service (over £1.7 billion) due to osteoporotic fractures is attributed to hip fractures.
Vertebral fractures
Vertebral fractures often go undetected. They commonly cause increasing back curvature, loss of height and chronic pain and are associated with back pain and disability. The economic burden is mainly due to outpatient care, provision of nursing care and lost working days.
Forearm fractures
Forearm fractures occur in perimenopausal women and also require hospital treatment. Fortunately the treatment usually leads to a good recovery of function.

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Question 4
Suggest what the long term complications of vertebral fractures might be.