Osteoporosis-Related Fractures- Burden, Risk Factors, and Preventive Strategies

Osteoporosis is a progressive skeletal disorder characterized by decreased bone mass and structural deterioration, leading to increased fracture risk, particularly in the wrist, hip, and spine. It is most prevalent among postmenopausal women due to hormonal changes and lower peak bone mass. The condition arises when the rate of bone resorption exceeds bone formation, a process influenced by both modifiable (e.g., diet, smoking, exercise) and non-modifiable (e.g., age, genetics, sex) risk factors. Although fractures related to osteoporosis, especially hip fractures, pose a significant economic and health burden, they are often undiagnosed until after injury. Screening techniques such as DXA and pQCT, along with mechanical tests like torsion analysis, can aid in early detection, though no single method reliably identifies all at-risk individuals. Hormone Replacement Therapy (HRT) is effective in reducing bone loss but remains controversial due to its associated cancer risk. Non-HRT treatments, including bisphosphonates, calcium, vitamin D, and calcitonins, offer alternative prevention strategies. Prevention remains the most effective approach, emphasizing adequate nutrition, regular weight-bearing exercise, and avoidance of smoking and excessive alcohol. While irreversible once bone strength is lost, early identification of risk factors and timely interventions, particularly around menopause, can significantly reduce the impact of osteoporosis and enhance long-term quality of life.