Fractures without falls: the rise of bone injuries in healthy adults

The common causes of fractures include accidents, sports activities and falls, but fractures can also occur without any cause, or from just slight bone damage. The medical term for this condition, a fracture that occurs without any external cause, is a pathological fracture. Fractures that are caused due to bone fragility or due to low energy trauma — equivalent to a fall from standing height or less) — are called fragility fractures.

The World Health Organization notes that owing to the global population growth and ageing, the annual incidence of total fractures worldwide is expected to continue to increase, driven by fragility fractures. This apart, people between the ages of 18 and 49 experience spontaneous bone fractures, which include spine and pelvis fractures that take place without major injuries. Why does this susceptibility develop in young and middle-aged adults, and what are the risk factors?

Why bone strength declines

Bone strength reduction occurs in adults due to multiple biological factors. Bone exists as a living tissue that undergoes continuous cycles of its components breaking down and getting rebuilt. The body needs essential nutrients, a proper hormonal system, sunlight and physical activity to sustain its bone health. Additionally, the body needs to maintain its equilibrium because any disruption that leads to decreased bone density can raise the risk of fractures.

Osteoporosis is a metabolic disease that results in diminished bone mineral density and structural alterations of the bones. While this is generally a condition seen in older adults, idiopathic osteoporosis causes bone fragility in younger adults who lack any identifiable medical condition.

Apart from osteoporosis, high doses of corticosteroids and anti-seizure drugs may result in severe bone tissue loss when used for extended periods of time. Chronic conditions such as metabolic disorders, ongoing infections, and the cancer treatment processes may also lead to bone structure damage.

Causes of fragility fractures

Common sites of fragility fractures include bones that wbear weight or are inecessary in routine everyday tasks, such as:

Spine and hip: Fractures at the spine and hip are regarded as critical injuries because they disrupt a person’s ability to move and live independently.

Wrist and upper arm: These frequently break during minor stumbles or simple reaching movements.

Knee and foot fractures: Knee and Foot fractures are common in individuals with weak muscles and in those who are overweight.

Modern risk factors

The strength of our bones is affected by different factors: both genetic and lifestyle. While factors that lead to changes in bone density include both natural ageing processes and hormonal shifts that occur because of menopause and genetic predisposition, the rate of bone loss can increase significantly due to lifestyle choices as well. Smoking, drinking in excess, and having an abnormally low body weight weakens the strength of the bones. Inadequate nutrition and lack of exercise further reduce bone strength because the body does not see the need for dense and strong bones due to limited activity.

Prevention and treatment

The first step to safeguarding people who might suffer bone injuries is through early detection. The three-pillar approach to bone health requires people to: consume enough calcium to fulfill their dietary requirements; get adequate direct sunlight because this helps produce essential vitamin D and ensure strength training to compel bones to undergo thickening, as the body needs to bear physical weight.

The treatment of the patient with a fragility fracture varies depending on the level of damage. After the necessary surgeries, doctors usually prescribe bone density drugs to help control the loss of minerals.

Rehabilitation focuses on two major aspects: mobility as well as preventing a second break. It includes physical therapy for balance, as well as changing daily habits. One fragility fracture puts a person in jeopardy of experiencing a second, which is why medical attention is required right away.

Boosting bone health

A fracture occurring due to a minor fall is a grave warning symptom of the condition of the individual’s bones. TBone health encompasses both accident prevention and essential care methods to maintain bone strength. Our body needs constant weight-bearing exercises, together with proper nutrition, to maintain its bone health.

(Dr. Pavan Chebbi is an orthopaedic and joint replacement surgeon at Apollo Spectra, Bengaluru-Koramangala. chebbipavan@gmail.com)