A low-trauma fracture — a fall from standing height or less — in an adult over 50 is itself evidence of skeletal fragility, whatever a later bone density result shows. Vertebral fractures are the most often missed: look for them on chest and abdominal imaging done for other reasons.
Before starting treatment, check calcium, vitamin D, renal function and, where relevant, causes of secondary osteoporosis. Ask about dental work before a bisphosphonate.
Then record the plan in the discharge letter so it does not depend on someone remembering at the next appointment.
- Treat a fragility fracture as a diagnosis of osteoporosis until shown otherwise
- Look for vertebral fractures on incidental imaging
- Check calcium, vitamin D and renal function before starting treatment
- Write the bone-protection plan into the discharge summary
Why it matters
The second fracture is often the one that ends independence.
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