Are all bone breakages because of osteoporosis or could there be another cause/causes?

Posted , 8 users are following.

Why I have asked this is that it is puzzling why some people break bones with only osteopenia or even no sign of that whilst others with bad osteoporosis are not breaking bones.

I suspect there should be more research.

Strength of bones may supply an answer or are thin people more prone than people with some cushioning from fat.

Then there is the evidence that says the drugs cause brittle bones so maybe other drugs people are on might as well?

Maybe we should be looking at other causes not just bone density?

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  • Posted

    I broke my leg and when I had the DXA scan they called it a fragility fracture. It was nothing of the kind. I slipped on ice putting my full weight on ice which I thought was soft snow and my leg twisted sideways and caused a tibial plateau fracture. It would have been worse if the ligaments had been torn instead so in a way it was a lucky break! But there was no way in the circumstances that something wasn't going to be damaged, so I've never thought it was a fragility fracture. Given that I'm a klutz I should be in little pieces by now, but I'm not. In fact when we were courting half a century ago my future husband nicknamed me "Crash".

  • Posted

    I tend to agree, I was diagnosed with osteoporosis after a bad fall onto concrete while climbing over a fence last year, don't ask I'm a klutz too.

    I broke hip and pelvis but I have fallen quite a few times in the last 20 years including a really bad motor bike accident, no bones broken, I used to do motor bike scrambling, loads of arguments with trees, no broken bones, I did have a really bad argument with a concrete post in my fourties when coming off my bike, radiologist said I was lucky not to break my femur but it just dented it, so was I suffering from osteoporosis then, I would think so, my sister has it and had a really bad fall last year onto her hip, no fractures.

    I am vitamin D deficient so take that but to be honest I refused alondronic acid, will see what next dexa scan says.

    • Posted

      What an awful experience! You describe a bone being dented. My first year at university I tumbled downstairs, mostly my dignity was dented, but for years after I was aware of a dent in my shin bone where I'd slammed into hard corner of one of the steps. Only 17 at the time, no osteoporosis.

    • Posted

      It does make you wonder when and how fast osteoporosis starts and becomes a problem, surely its a slow process and if its so much of a problem why don't they check you when your younger.

      Maybe then I would have been more careful, are dents common, has yours gone, mine still showed up on xrays

    • Posted

      I have no idea.  I certainly couldn't have been at risk when I was younger, considering how clumsy I can be, and all the knocks and tumbles I've had over the years!  i remember one time I had one of my children on my back in a carrier, and there was an irregularity in the sidewalk and I fell.  It was awkward getting up with a tot on my back, but I did and was no worse for wear.  Another time, same problem with irregularity underfoot, this time at dusk, when I tripped and fell into the street, scraped my glasses (which protected my eyes thank goodness) and broke a couple of teeth, but my bones were absolutely fine.

  • Posted

    I'm a klutz as well as Anhaga. I had almost the same experience but am a klutz x 3 because I cracked the patella first - tripped and crashed on a pavement. I didn't count that as a fragility fracture. I think it could have happened to anyone. 2 months later I slipped in the kitchen. I think my balance was not quite recovered and I landed in the same way as Anhaga and damaged all the soft tissue, but no break - yet!  3 months later I slipped on soft snow, landed on a path causing a fracture between the condyles of the fibia and a tibial plateau fracture. TPFs can be very painful. Commiserations to anyone who suffers one. Same twisted motion. My husband wondered why I was lying in the garden in the snow with my head under a bush!  He regularly wonders why I have to throw myself on the ground. Very funny! I'm 71 but very active so am not too worried about fragility, but was slightly disconcerted when I read that taking Depo Provera (which I did when abroad in my 20s) can cause osteoporosis. That can't be helped now, so I am soldiering on without AA or anything else and will ask for another Dexa scan in the near future to see how I am getting on. 

    • Posted

      Owch!  You certainly didn't do yourself any favours.  Hope all the breaks healed well.  I was warned that the very slight OA I have in knees (no problems) would probably get worse from the break, but three years later no sign of OA deterioration.

    • Posted

      Thanks. They seem to have healed well because I have worked so hard on exercise and strengthening. I was warned that I would need a new knee because of arthritis but I don't seem to have any. I am determined to prove them wrong!  Well done to you too.

  • Posted

    My only fracture was as a result of a high impact fall down a flight of concrete stairs crashing at force on a concrete edge of stair directly against my spine, so osteopenia or not I'm sure I would have sustained a fracture. 

    As you say Kathleen a broader and more in depth root cause need to be established.

    The assumption is because I have osteopenia that is why I fractured, someone needs to capture maybe at DXA scan stage or fracture stage standard information on a shared database from each patient to establish at minimum;

    Level of Impact that caused fracture

    Bone density T score 

    Any previous falls that didn't sustain a fracture 

    Any supplements regularly taken for how long a period 

    Any prescribed Osteoporosis drugs taken, for how long a period 

    BMI. etc etc, 

    This data would be very simple to capture in the normal consultation with a patient and would save the NHS a fortune in unnecessary drugs being prescribed aside of the  drugs prescribed to manage the side effects caused by the osteoporosis drug!  

     

    • Posted

      I think you are right Dee. Most people would have broken something in this situation. I don't fall but have sustained 3 fractures.

    • Posted

      Hi Dee,  You asked " Are All bone Breakages Due to Osteoporosis?". (OP).  We seem to have determined that they are not. You described a fall down concrete stairs. I think most people who hall down concrete stairs would fracture. Anhaga mentioned a fall and a nasty twist, which also doesn't shout OP either. Someone else reported a fracture after a motor bike accident (ie. impact at speed), not due to OP. . . . 

      I think the 'clinically significant' detail is whether or not one falls from from a STANDING position. The explanation for this is that a normal human bone is well able to withstand a fall from this height. If then a bone is broken in this event, it should be investigated. And as one female in 3 aged over 50 has OP (one male in 4),  this fall often leads to a dexa scan and then often a diagnosis of OP or low bone mass. Then, to complicate things even further, some people even with very low bone density (ie. significant OP)  don't fracture and some with osteopenia do. This may have to do with a distinction between bone density and bone quality - simply put some bone quite simply is stronger or of better quality than others . . . . 

      Yes, fat padding is of benefit to prevent fracture esp. of the hip, but generally fat people tend not to develop OP in the same numbers as thin people. It seems that their extra weight, while bad for their joints, is actually good for their bones ie. their bones get a good work out while carrying the extra weight. . .. 

      I attend an OP Pilates class and all of the participants are thin. The class after ours is for ' body training' or something  like that - and ALL the group are  " roundy" . . . . J

       

    • Posted

      Sorry Kathleen, senior moment - Just realised it was you, not Dee, who posed the interesting question!

      Hope you're keeping well.  

      J

       

    • Posted

      I was wondering reading all that Juno lol.

      I struggle with weight and eat only 1200 calories a day due to weight issues.

      I have always been a bit clumsy usually not looking where I am walking or hurrying.

      For the last two years I use a wheeled walker at home and out which is very occasional these days.

      I think the whole thing is more complicated than has been dealt with to date. I guess cancer is more important to have research moneys directed at it than non life threatening diseases like osteoporosis.

      My back is not good because of four things not just osteoporosis. I never suspected I would have a bad back, in fact, I always thought my back was very good.

      Arthritis, bulging discs, mild scoliosis and osteoporosis has changed all that.

      I only had a bone density scan at 70 years of age because my sister promoted me to do so as they were free. Maybe, ignorance is bliss after all.

      No broken bones happened to prompt an earlier investigation.

      Hope you are enjoying life Juno,

      Cheers. Kathleen.

    • Posted

      Correction...my sister prompted me to do that

      Stupid auto correct...it continually corrects words into others when there is no need to do so

    • Posted

      For those who need it, a wheeled walker is really helpful, not least because the wheels meet any obstacle first - and therefore you're unlikely to trip and fall which is so important.. . . .

      However, if I were you, Kathleen, I would look into some balance exercises which would give extra protection and also make you feel less vulnerable. 

      J

    • Posted

      Unfortunately it is not that simple for me, my back spasms where the nerve goes down into the sacroiliac and I cannot afford to risk being caught off guard.

      I have also had bouts of vertigo so it is not that simple for me.

    • Posted

      At my information group for OP the ladies who were in a similar position to you, were advised to still hold onto their walking frame but lift one foot off the ground. Just enough for the body weight to be transfered through the other hip.
    • Posted

      Sorry computer problems this morning. 

      It would be worth a try and even if you start with only 5 seconds each side, you can work up to a couple of minutes over time. It also helps balance but you have your walker there in front of you, just in case.

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