The bones are designed to withstand large impacts and pressure. Most bone fractures are caused by accidents such as a fall, blows, among other causes. But a loss of bone density and poor bone quality makes it weak and not very resistant, and it may experience so-called spontaneous or fragility fractures , for no apparent reason.

The breaking of bones due to osteoporosis or fragility fractures have become more and more frequent, due to the increasing increase in the adult population, they point to an imminent increase in osteoporosis worldwide. It occurs mainly in women more than in men, being prevalent in women with white skin and its appearance more likely as one ages.

The National Institute of Health (NIH) considers osteoporosis as a generalized skeletal disorder, characterized by an alteration in bone strength that predisposes the person to a greater risk of breaking bones .

The Spanish Society of Rheumatology mentions that these fractures are caused by low-impact trauma. A fall, while standing or sitting, the most frequent and relevant are those of the femur, the spine and the forearm.

It could be said that osteoporosis is the disease that most commonly could cause bone breakage , but there is a little known disease called Osteogenesis Imperfecta (OI) or “crystal bone disease” that is characterized by bone fragility resulting in a bone vulnerable to external and internal forces, conditioning the appearance of frequent fractures in the event of minimal or non-existent trauma, varying degrees of short stature, progressive skeletal deformities and also causes osteoporosis.

The rupture of long bones is probably the most dramatic situation that can occur in OI, OI can generate around 12 fractures throughout the life of the person suffering from it. These fractures, as well as osteoporosis, increase in periods of rapid growth such as puberty.

Prevention of fractures

In the case of osteoporosis to prevent fractures several methods must be involved such as:

  • Initiation of therapy including lifestyle modifications
  • Anti-osteoporotic medication and prevention of falls.
  • Control the weight.
  • Exercise regularly.
  • Abolish the consumption of tobacco and alcohol.
  • Pharmacological management with bisphosphonates has shown that it increases bone mineral density by 3.8 to 5.4%, and prevents loss of bone density by up to 3.7%.
  • Supplementation such as vitamin D, calcitonin, and hormone replacement therapies increase bone density from 1.9 to 3.8%, thus reducing the risk of fracture by 70%.

Avoid Accidents with Extra Caution

In addition to the methods mentioned above, studies on the prevention of fractures in osteoporosis recommend measures to avoid falls that are the root cause of bone breakage . These measures include:

  • Correction of visual acuity alterations.
  • Surgical correction of cataracts.
  • Treatment of dizziness and vertigo.
  • Treatment of deficits due to cerebrovascular disease and neurological disorders.
  • Study of the environment: adequate lighting at home. Adapting the bathroom and avoiding “loose” objects: children’s toys, rugs, cables, among others.

Regarding OI, there is a consensus to perform orthopedic surgical treatment to avoid fractures in the long bones, later resorting to the use of the orthosis and various equipment to aid mobility and standing up.

As for the orthosis as therapy or prevention of fractures , it is an external device applied to the body to generate support by modifying the structural aspects of the affected neuromusculoskeletal system. It is not only used as a substitute for a cast after surgical treatment, but as mentioned above as a means of support to help the mobility of people with OI where surgical treatment is not the alternative.

The orthosis has the ability to reduce the number of fractures of the tibia and femur with the use of appropriate, since by positively generating mechanical stress and muscle tension, bone density is increased, which prevents fractures and at the same time the osteoporosis, this being a predisposing factor to bone breakdown for this disease.

As in osteoporosis, in OI constant physical therapy is recommended, of course depending on the person’s facilities, for this reason the orthosis is used to increase physical activity. Also to prevent fractures , bisphosphonate treatment is used as in osteoporosis, since these prevent osteoclastic activity (bone degradation) and thus avoid fractures .

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses.He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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