‘Fragile’ bone fractures: making the first fracture the last
Research team aims to develop, trial and cost locally tailored care that will prevent repeat bone fractures.
An older Australian has a minor fall and ends up with a painful arm or leg. Maybe they don’t want to bother the doctor because it will get better of its own accord and all will be well – won’t it? Or maybe they see a doctor, the injury is treated and they recover. But why did the bone break if the injury was minor, and shouldn’t the underlying problem be treated so it doesn’t happen again?
Older people who break bones after only minor incidents may be suffering from osteoporosis and not know it. Without a diagnosis and appropriate treatment, they are at risk of further fractures, declining health, hospitalisation and even death.
However, the patchwork nature of our health system means there are many ways patients can fall through the cracks, especially if the pain or discomfort has passed.
My father died in hospital six weeks after falling and breaking his hip, and that is too common a story.
A team from the Musculoskeletal Clinical Academic Group of the Sydney Partnership for Health Education Research and Enterprise (SPHERE), led by Professor Lin Perry from the University of Technology Sydney (UTS), has been awarded almost $900,000 by the NHMRC to improve how people with osteoporosis are identified and safeguarded against more bone breaks.
“Osteoporosis is a largely silent condition and people are often unaware they have it. If a person has osteoporosis, a fracture can occur with minimal trauma and may not be identified at the time – people don’t always see their GP or go to the emergency department after a fall or accident,” Professor Perry said.
“Of course, bones do heal, even with osteoporosis, but bones that have osteoporosis are what we call ‘fragile’. That first fracture flags what may otherwise be an unidentified risk. Bones that break easily once are likely to do so again unless treatment is started to strengthen them.”
Professor Perry said best practice treatment for osteoporosis requires a series of assessments and referrals working seamlessly across hospitals and GP surgeries.
“But with the best will in the world, there are multiple points where it is possible for a patient to slip through the net,” she said.
“We’re talking about people who can have minimal or no symptoms – in cardiovascular disease, for example, the damaged organ is good at signalling to its owner that something is wrong. In general, people respond to chest pain very differently to, for example, a painful wrist.”
Professor Perry’s research team will work with four major Sydney hospitals on the three-year project. Their aim is to develop, trial and cost locally tailored care that will prevent repeat bone fractures.
For Professor Perry, the issue is both professional and personal: “My father died in hospital six weeks after falling and breaking his hip, and that is too common a story.
“This project will help health services learn from each other and take advantage of the spotlight on osteoporosis that this grant provides.”
Professor Lin Perry’s grant of $897,730 is awarded by the Medical Research Future Fund for Keeping Australians Out of Hospital.
- 1.2 million Australians are affected by osteoporosis: 25% - 30% of postmenopausal women and 10% of men aged 50 years and older
- Osteoporosis doubles the risk of bone fracture in men and women, with Australians aged 50+ experiencing over 140,000 fragile bone fractures every year
- Fracture doubles the risk of death, with men at higher risk of post-fracture death than women
- One in five people with a hip fracture dies within one year; one in two men and one in three women aged 60+ die within 5 years of a minimal trauma fracture
- Osteoporosis has been estimated to cost the Australian budget $3.8 billion per year
- Bone health can be improved through nutrition, exercise, supplements such as Vitamin D and medicines to strengthen bones