Fragility Fracture
Low-trauma fractures in older adults — acute care, bone protection and falls prevention
Fragility fractures occur after low-energy trauma and are a major marker of underlying bone fragility. Effective care combines acute fracture management with structured secondary prevention to reduce future fractures, disability, and loss of independence.
Clinical overview
A fragility fracture is usually caused by trauma from standing height or less and often indicates osteoporosis risk. Hip and vertebral fractures are particularly associated with morbidity, mortality, and functional decline in older adults. Early recognition, pain control, and coordinated orthopaedic-geriatric care are central to recovery.
Treatment and prevention pathway
NICE-aligned management includes prompt acute fracture care, falls risk assessment, and secondary prevention with bone-health treatment where indicated. Calcium/vitamin D optimisation, anti-osteoporosis medication selection, rehabilitation, and medication review are key elements. Fracture Liaison Service follow-up improves long-term outcomes and reduces recurrent fracture risk.
Escalation and long-term safety
Urgent escalation is needed for suspected hip fracture, inability to weight bear, neurological compromise, or recurrent falls with serious injury risk. Long-term safety requires adherence support, functional rehabilitation, home hazard reduction, and regular reassessment of falls and bone-health risk. Hidden trigger-word care-plan content provides the exam-focused BNF/NICE practical pathway.