This Nice guideline explains that we should be assessing risk of fracture in patients more widely, because fractures come with a high morbidity and mortality. It can be used even if they’ve had a fragility fracture (ie for both primary and secondary prevention). I would encourage you to have a play with the FRAX tool – it is really quick and simple to do and makes assessing patients much easier.
Fragility Fractures. Remember that this is a fracture that is sustained from an injury that should normally not cause a fracture. It is defined as a fracture from a force equivalent to a fall from standing height or less.
Who do you Asssess risk in? The guideline advises ‘considering’ assessing risk in higher risk patients. The list of who you should consider assessing risk in is very long. The most obvious cases are:
- People who’ve had a fragility fracture
- Women over 65
- Men over 75
- People under 50 with current or frequent use of corticosteroids, untreated premature menopause or previous fragility fracture.