Breaking the fracture cycle

A recent analysis of the Geelong Osteoporosis Study has found that people of all ages who experience a bone fracture are more likely to experience further fractures, compared to the general population.

Deakin researcher, Dr Kara Holloway, and her colleagues at the Epi-Centre for Healthy Ageing, analysed the medical history of 1538 males and 1731 females, with an age range of 21 to 110 years, enrolled in the Geelong Osteoporosis Study - a population-based study within the Barwon region.

“We found that experiencing a fracture in childhood increased the risk of having another fracture in adolescence for males by 21.7% and for females by 8.1%,” said Dr Holloway.

“Males with a fracture in adolescence have an increased risk of another fracture in early adulthood (11.5% increase) and mid-adulthood (13% increase) and, similarly, males who have a fracture in young adulthood or mid-adulthood also have an increased risk in the following age group.”

“Females also showed an increased risk. Those who had a childhood or adolescent fracture were at increased risk of later fracture in young adulthood (4.3% and 10.5% increase respectively), and a prior fracture in older adult life increases the risk of another fracture by 14.9%.”

Dr Holloway surmised that the likelihood of fracture recurring could be due to interrupted bone growth, particularly in young people, or lifestyle factors, such as recklessness and drinking, or osteoporosis, especially for post-menopausal women.

She explained that preventing fractures is important for people of all ages, due to its high personal cost and the public health burden, in terms of ambulance services, hospitalisations, emergency department and outpatient services, rehabilitation, aged care and community services.

The personal cost of fracture can be demonstrated by another study conducted by Dr Holloway’s group, which examined the incidence and disruption caused by foot and ankle fractures recorded by the Geelong Fracture Grid, which collects data from all fractures in the Barwon region.

“Foot and ankle fractures are usually associated with a substantial amount of time off work, inability to drive, the need to use a walking aid and inability to participate in sporting activities,” said Dr Holloway.

"It can contribute to loss of independence and people may need assistance with daily tasks, such as housework or personal care, for up to 12 months afterwards."

“While it is not easy to prevent an accident, there are precautions that people can take, especially the elderly, in terms of ensuring good visibility, even floor surfaces and handrails, to reduce their chances of falling and injury.”

Dr Holloway’s research has been published in two international journals: “Osteoporosis International” (September 18, 2014) and “Clinical Research on Foot & Ankle” (July 31, 2014).