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Imminent fracture risk

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Abstract

The clinical significance of osteoporosis is in the occurrence of fractures and re-fractures. The main risk factor of sustaining a fracture is a previous one, but a recent fracture is a better fracture risk factor than fracture history. The role of the recency of fracture has been shown for both vertebral and non-vertebral fracture risk. This imminent risk is explained by both bone-related factors (underlying osteoporosis) and fall-related factors (including those related to postfracture care). Such a short-term increased risk has been shown also in patients initiating corticosteroids and in frail osteoporotic subjects with central nervous system (CNS) diseases or drugs targeting CNS, and thus a high risk of falls. Patients with an imminent (i.e. 2 years) risk of fracture or refracture should be identified in priority in order to receive an immediate treatment and a program of fall prevention.

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Authors

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Correspondence to C. Roux.

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Conflict of interest

Christian Roux received research grants and/or honoraria from the following: Alexion, Amgen, Lilly, and UCB. Karine Briot received research grants and/or honoraria from the following: Amgen, Lilly, MSD, and PFIZER.

Additional information

Learning objectives

On completion of this article, you should be able to recognize the following:

1. A recent fracture is a better fracture risk factor than fracture history.

2. The risk of falls must be assessed in osteoporotic patients with or without a recent fracture.

3. Frail elderly patients with osteoporosis and a high risk of falls can have an imminent risk of fracture.

4. Patients with an imminent (i.e. 2 years) fracture risk can be identified and should receive the highest priority for treatment and fall prevention.

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Roux, C., Briot, K. Imminent fracture risk. Osteoporos Int 28, 1765–1769 (2017). https://doi.org/10.1007/s00198-017-3976-5

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