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Recurrent Fragility Fractures

A Cross-sectional Analysis

Dang, Debbie Y., MD, PhD; Zetumer, Samuel, BA; Zhang, Alan L., MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: January 15, 2019 - Volume 27 - Issue 2 - p e85–e91
doi: 10.5435/JAAOS-D-17-00103
Research Article

Introduction: Despite growing rates of fragility fractures, there has been a lack of research investigating the risk and characteristics of recurrent fragility fractures.

Methods: The Medicare Standard Analytic Files database was used to identify patients from 2005 to 2009 who were older than 65 years, had a diagnosis of osteoporosis or osteopenia, and sustained a fragility fracture of the proximal humerus, distal radius, hip, ankle, or vertebral column. The incidence and type of recurrent fragility fracture were tracked over a 36-month period.

Results: A total of 1,059,212 patients had an initial fragility fracture from 2005 to 2009. Of these patients, 5.8% had a subsequent fragility fracture within 1 year for their initial fracture, 8.8% within 2 years, and 11.3% within 3 years. At 3-year follow-up, hip fractures were the most common type of subsequent fracture, regardless of the initial fracture type (6.5%, P < 0.001). Vertebral compression and proximal humerus fractures (13.8% and 13.2%, respectively) were most likely to be associated with a recurrent fragility fracture.

Conclusion: Patients who have any type of fragility fracture have a notable risk of subsequent fractures within 3 years, especially hip fractures. These patients should be evaluated and treated for underlying risks factors, including osteoporosis and/or osteopenia.

Level of Evidence: Retrospective, level III

From the Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA.

Correspondence to Dr. Zhang: Alan.Zhang@ucsf.edu

Dr. Zhang or an immediate family member serves as a board member, owner, officer, or committee member of the American Orthopaedic Society for Sports Medicine. Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Dang and Mr. Zetumer.

© 2019 by American Academy of Orthopaedic Surgeons
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