Osteoporosis and Fragility Fracture

Abstract

Osteoporosis is a major threat to musculoskeletal health in older adults. Osteoporotic fractures or fragility fractures have been recognized as geriatric conditions associated with various and complex problems that significantly compromise whole-body conditions and functions in addition to the musculoskeletal problems due to fracture per se. Of all fragility fractures, the care and rehabilitation of patients with hip fractures pose critical challenges in terms of functional outcomes and medical costs in a superaged society. Vertebral fracture is the most common fragility fracture, reducing health-related quality of life by causing pain and decreasing physical capabilities. More attention must be paid to mortality and morbidity profiles, loss of independence, and their resulting clinical and socioeconomic impacts. Comprehensive and systematic rehabilitation can minimize complications and increase the success of medical and surgical treatments, thereby lowering the extent of impairment. The most common cause of osteoporotic fracture is a fall-related injury. Epidemiologic data and the healthcare systems regarding the occurrence of falls, risk factors for falls, and postfall outcomes in older adults show that such problems are already of major international concern. We will review the recent trends in the management of osteoporosis and fragility fractures. Comprehensive and integrated rehabilitation for fragility fractures including exercise management and fall prevention will be discussed. This chapter focuses on the rehabilitative management of hip and vertebral fractures, which are the most common fragility fractures causing severe dysfunction in the very elderly. © 2018 Elsevier Inc.