Almost 20,000 older people suffer bone breaks each year from low-impact falls, many of which could be prevented, according to a new report.
Screening for osteoporosis and better management of patients who have suffered a first fracture could reduce the overall number of so-called “fragility fractures” occurring in Ireland, it says.
Fragility fracture are broken bones sustained from a minor trip or bump. They can be extremely debilitating and can have a devastating impact on a person’s ability to live independently.
“Ideally all fractures would be prevented through increased public awareness of, and screening for osteoporosis, but given the sheer numbers at risk, managing those who have sustained an index/first fracture would be of significant benefit in reducing subsequent fracture numbers,” the annual report of the Fracture Liaison Service for 2022 states.
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Osteoporosis, leading to increased bone fragility, affects an estimated 300,000 to 500,000 people in Ireland. Half of all women aged over 50, and one-quarter of men, will suffer an osteoporosis-related fracture, it is estimated.
Some 3,806 hip fractures were reported in the 2021 Irish Hip Fracture Database. UK experts estimate there are about five non-hip fragility fractures for every hip fracture, equating to over 19,000 fragility fractures occurring annually in Ireland.
This is thought to be a conservative estimate because only those admitted to hospital are captured in official data, according to the report.
The database recorded 3,195 non-hip fragility fractures in 2022, but this is thought to be just one-third of the actual number. Over 80 per cent of these were in women. The media age at fracture was 69 years for women and 70 for men.
Noting that only 69 per cent of trauma hospitals have a fracture liaison service in place, the report calls for a fully resourced service where patients presenting with fragility fractures are assessed, tested for osteoporosis and placed on treatment plans.
Spine fractures need to be prioritised, it also says, as these patients are at greatest risk of further fractures. However, only 26 per cent of the expected number of spine fractures were identified last year.
The report identifies a need for greater follow-up care with just 35 per cent of patients recommended anti-osteoporosis medication last year, down from 53 per cent in 2021. Only 11 per cent of patients were referred to start strength and balance training and just 5 per cent started within 16 weeks of their fracture.
The national Fracture Liason Service was established by the National Clinical Programme for Trauma and Orthopaedic Surgery in 2018.
