Fragility Fracture

Our Fragility Fracture Program is specially designed to improve the care of anyone who experiences a bone break due to fragile bones, often an undiagnosed weakness (osteopenia) or thinning or brittleness (osteoporosis). This can mean taking a tumble from standing height or less, or incurring any other trivial injury that would not normally cause a fracture, such as participating in an everyday activity. We want to get you back to your normal level of activity faster and, more importantly, prevent another fracture.

Why Choose Ohio State for treatment of fragility fracture?

The Ohio State University Wexner Medical Center is designated a premier certified Geriatric Fracture Center by the International Geriatric Fracture Society, one of only 25 centers worldwide. This makes us a foremost authority on delivering evidenced-based, patient-centered treatment for geriatric or fragility fractures and geriatric orthopedic care.

Our Fragility Fracture Program provides a novel approach to medical care and education for patients and their families. Features include:

• A specialized team approach that includes fellowship-trained orthopedic surgeons, emergency medicine physicians, endocrinologists, physician assistants, nurses, nurse practitioners, physical therapists, occupational therapists and nutritionists
• Improved pain management strategies that reduce medical complications while enhancing patient comfort
• A rapid admission process that gets patients to surgery in less than 24 hours
• Fall risk analysis with balance training designed to reduce the risk of future falls
• Follow-up outpatient visits that include a post-surgical visit, Bone Health Clinic or High-Risk Osteoporosis Clinic appointments and a bone density test (as necessary)

We aim to improve your ability to return to the level of activity you enjoyed before the injury, in a shorter period of time and with fewer complications. 

Assessing your bone health and diagnosing risk for fragility fracture

Because so much of what we do starts with diagnosing osteoporosis and helping you understand and deal with the condition, we begin your evaluation with a physical exam and medical history. As part of our evaluation, we use the FRAX®, or Fracture Risk Assessment tool, to evaluate your risk of fracture. We also routinely order a DEXA scan, an X-ray that measures bone mineral density. Along with our examination, these diagnostic tests and assessments help us put you in a risk category to determine the best, most personalized treatment plan for you. 

The American Orthopaedic Association’s Own the Bone® quality improvement plan is a key component of our prevention and education program. Our participation in Own the Bone® gives us additional tools and support to help you reduce future fracture and the impact of osteoporosis, and materials to educate you about the importance of bone health and proper osteoporosis treatment. 

Osteoporosis is a disease you can do something about. It can be prevented, detected and treated!

How we treat fragility fractures 

Older individuals often have a decreased ability to respond to physiologic stress and multiple conditions that make treatment and recovery from illness or injury more challenging than in the younger patient. This contributes to the risk of a second fragility fracture being significantly higher than the risk for the initial fracture.

Our Fragility Fracture Program offers these services and treatments to speed recovery and prevent future fracture:

• Nutrition counseling and education to promote healing, prevent malnutrition and reduce fracture risk
• Physical activity recommendations, including balancing and weight-bearing exercises and physical therapy to improve strength and agility
• Screening for important vitamins and minerals, such as calcium and vitamin D, and potential prescription suppplementation to ensure adequate daily intake
• Clinical trials to provide you with access to promising and proven treatments not yet available to the general public
• Surgical and non-surgical treatments for fractures

How to prevent future falls and fractures

The last thing you want to experience is another fall and broken bone. If you have had a fragility fracture, you are very likely to have osteoporosis. You are at higher risk for a future fracture, especially over the next year.

It is important you receive proper fall prevention education and screening. Our prevention clinic can identify risks to reduce or prevent future falls. You can also take these three steps to prevent fractures:

Be active. Exercise or do hard work for at least 30 minutes every day. Be sure to include exercises that improve balance. Our experts can provide you with specific movements to do and also ones to avoid.

Keep your bones strong. Calcium plays an important role in building stronger bones early in life, and keeping bones strong and healthy later in life. When the diet does not have enough calcium for our body’s needs, calcium is taken away from the bones. Get three to five servings of dairy a day or take supplements to get the daily recommended amounts of calcium and vitamin D. What’s a serving of dairy? Eight ounces of milk, three or four cheese cubes or six to eight ounces of yogurt.

Adults age 50 and older need:

• Calcium: 1,200 milligrams (mg) every day. The body can only absorb 500-600 mg at one time. Calcium from food and supplements should be spread throughout the day.
• Vitamin D: 800-1,000 international units (IU) every day. This can be taken as a single dose.

People who get the recommended amount of calcium from foods do not need to take a calcium supplement. These individuals still need to take a vitamin D supplement.

Prevent falls.  Women have a 1-in-2 chance of having a fracture due to osteoporosis after the age of 50, and men have a 1-in-4 chance of having a fracture due to osteoporosis after the age of 50.  Falls can be caused by loss of balance, muscle weakness, joint stiffness, poor vision, dizziness, medication side effects and problems in the environment. Many seniors are afraid of falling, so they reduce their activity level, which further increases weakness and risk of falling. Have a fall risk assessment performed at your home and make changes to prevent falls. 

Taking care of our community

The Wexner Medical Center offers Ortho CONNECT, a mobile outreach service, that delivers specialty medical care to patients in select skilled nursing facilities. An advance practice provider makes on-site visits offering these services: 

• Follow-up visits and checkups  
• Procedures such as cortisone injections for arthritis, splint or cast management for fractures
• Acute injury assessments (portable X-rays, workup, etc.) 
• Preparing you for direct admission to the hospital (pre-op workup, etc.)

Additionally, we have established partnerships with local paramedics, senior centers and social resources to improve care for older orthopedics patients and prevent subsequent fractures. This includes:

• Fall prevention education
• Installation of grab bars, toilet rails and night lights
• Research to better understand the factors contributing to falls in homes and frequent “911” calls