ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2020
Fracture risk following high-trauma versus low-trauma fracture: a registry-based cohort study.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 8 of them syntheses that pooled it.
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Who cites it
60 citing papers in PubMed, 8 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- A meta-analysis of smoking and fracture risk to update the FRAX® tool.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Pooled it
- Body mass index and subsequent fracture risk: a meta-analysis to update FRAX.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Pooled it
- The 2024 UK clinical guideline for the prevention and treatment of osteoporosis.Archives of osteoporosis · 2025Guideline
- Family history of fracture and fracture risk: a meta-analysis to update the FRAX® risk assessment tool.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Pooled it
- [Osteoporosis-Definition, risk assessment, diagnosis, prevention and treatment (update 2024) : Guidelines of the Austrian Society for Bone and Mineral Research].Wiener klinische Wochenschrift · 2024Guideline
- Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023Pooled it
- UK clinical guideline for the prevention and treatment of osteoporosis.Archives of osteoporosis · 2022Guideline
- Systematic review of major osteoporotic fracture to hip fracture incidence rate ratios worldwide: implications for Fracture Risk Assessment Tool (FRAX)-derived estimates.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2021Pooled it
- Osteoporosis medication initiation after proximal humerus fractures is low, but associated with decreased secondary fragility fracture risk.OTA international : the open access journal of orthopaedic trauma · 2026Article
- Injury-driven stromal exhaustion disrupts intrinsic regenerative capability.Nature communications · 2026Article
- An index of net bone formation relative to resorption is associated with incident fracture during the menopause transition and postmenopause.JBMR plus · 2026Article
- Increased fracture risk associated with iron-deficiency anemia: a population-based propensity score matched cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Suboptimal osteoporosis screening rates persist in patients on long-term glucocorticoid therapy: current experience within an academic health system.Journal of clinical & translational endocrinology · 2026Article
- Osteoporosis treatment indications following fracture: identifying relevant fracture sites for Fracture Liaison Services.Archives of osteoporosis · 2026Article
- A longitudinal dataset of hypertensive osteoporotic fracture patients: treatments and long-term outcomes.Scientific data · 2026Article
- Secondary fracture prevention after vertebral, femur or pelvic fracture at US academic medical center.Archives of osteoporosis · 2026Article
- Understanding factors that impact patient access and engagement with biomedical and traditional care for hip fractures in The Gambia: An ethnographic study using a social ecological model.PLOS global public health · 2026Article
- Which Patients in the FLS Should Be Prioritised for a DXA Scan Within 12 Weeks?Journal of clinical medicine · 2025Article
- [Diagnostics and treatment of osteoporosis in 2025 : An update on current guidelines].Innere Medizin (Heidelberg, Germany) · 2025Review
- Osteoporosis in Men: an Overlooked Patient Population.Current osteoporosis reports · 2025Review
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9 authors at 7 institutions in 4 countries.
Funding
Abstract
Prior high-trauma fractures identified through health services data are associated with low bone mineral density (BMD) and future fracture risk to the same extent as fractures without high-trauma.
introductionSome have questioned the usefulness of distinguishing high-trauma fractures from low-trauma fractures. The aim of this study is to compare BMD measurements and risk of subsequent low-trauma fracture in patients with prior high- or low-trauma fractures.
methodsUsing a clinical BMD registry for the province of Manitoba, Canada, we identified women and men age 40 years or older with fracture records from linked population-based healthcare data. Age- and sex-adjusted BMD Z-scores and covariate-adjusted hazard ratios (HR) with 95% confidence intervals (CI) for incident fracture were studied in relation to prior fracture status, categorized as high-trauma if associated with external injury codes and low-trauma otherwise.
resultsThe study population consisted of 64,428 women and men with no prior fracture (mean age 63.7 years), 858 with prior high-trauma fractures (mean age 65.1 years), and 14,758 with prior low-trauma fractures (mean age 67.2 years). Mean Z-scores for those with any prior high-trauma fracture were significantly lower than in those without prior fracture (P < 0.001) and similar to those with prior low-trauma fracture. Median observation time for incident fractures was 8.8 years (total 729,069 person-years). Any prior high-trauma fracture was significantly associated with increased risk for incident major osteoporotic fracture (MOF) (adjusted HR 1.31, 95% CI 1.08-1.59) as was prior low-trauma fracture (adjusted HR 1.55, 95% CI 1.47-1.63), and there was no significant difference between the two groups (prior trauma versus low-trauma fracture P = 0.093). A similar pattern was seen when incident MOF was studied in relation to prior hip fracture or prior MOF, or when the outcome was incident hip fracture or any incident fracture.
conclusionsHigh-trauma and low-trauma fractures showed similar relationships with low BMD and future fracture risk. This supports the inclusion of high-trauma fractures in clinical assessment for underlying osteoporosis and in the evaluation for intervention to reduce future fracture risk.
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