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One fracture, two fracture, three fracture……enough!

One fracture, two fracture, three fracture……enough!

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By Irwin Lim, Rheumatologist

On the rainy weekend, I attended a provocative lecture by a world expert in osteoporosis, Professor Markus Seibel. He spoke about the clear need for coordinated interventions in osteoporosis.

Why bother?

“In Australia, 67,000 osteoporotic fractures occurred in 2001. By 2007, this figure had increased to 87,100 fractures and by now has probably passed the 90,000 mark. Osteoporosis costs the Australian tax payer over $7 billion per year. For the individual patient, osteoporotic fractures cause pain, disability, social isolation, depression and premature death.” This quote appears in the latest issue of Osteoblast, an Osteoporosis Australia publication.

We bother to highlight this because Osteoporosis is a BAD disease with BIG consequences.

There are many risk factors for osteoporosis, and doctors need to be vigilant for these. Unfortunately, this “silent” disease is too often forgotten.

The greatest risk for having another osteoporotic fracture is having already had one. Prevention strategies are therefore best targeted at this high risk group.

In this group, the disease is no longer silent.

Sadly, most patients presenting to hospitals with an osteoporotic fracture (also referred to as a minimal trauma fracture) are getting a surgical fix or a cast, but not assessed and therefore, not treated for osteoporosis. Between 20-50% of all patients who have suffered one of these osteoporotic fractures will have subsequent fractures.

This of course causes pain, suffering, disability and loss of independence. It also costs hospitals, and therefore governments, a lot of bedtime and money.

Professor Seibel and a team of clinicians and researchers at Concord Hospital, Sydney, recently published the 4-year follow-up results of a coordinated fracture liaison service on re-fracture rates in patients with previous minimal trauma fractures.

A simple coordinated team approach to actively identify these patients followed by diagnostic tests, and simple, standard treatment resulted in a reduction of 80% of recurrent fractures after an initial osteoporotic fracture! Health economic analyses also indicate that this sort of fracture liaison service is highly cost effective to society.

This effective prevention of a bad disease does not depend on high tech measures. It just depends on the health system caring enough to set up a simple fracture prevention service.

To date, most hospitals in Sydney do not have such fracture liaison services. I am not aware of any such services set up in the community setting.

Don’t you think it’s worth preventing the next fracture in the group of people at highest risk of developing recurrent fractures? BJC Health does.

Dr Irwin Lim is a rheumatologist and a director of BJC Health.

BJC Health provides a connected care multidisciplinary team philosophy to deliver positive lifestyle outcomes through a holistic approach to those with degenerative & inflammatory arthritis, tendon injury and lifestyle diseases. Our clinics are located in Parramatta, Chatswood and Brookvale. Contact us.

This blog focuses on arthritis-related diseases, healthcare in general, and our Connected Care philosophy.

Stop Press: Stopping recurrent fractures after suffering a fracture from weak bones (osteoporosis) is a priority. We are going to run a Refracture Prevention Program at our Parramatta rooms to try & stop bones breaking.


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