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Risk of second fracture is highest immediately after first

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A new study suggests that the risk of a second major osteoporotic fracture is greatest immediately after a first fracture.

An international research team analysed data on more than 5,000 people who were part of the Reykjavik Study during 1967-1991. Of the 5,039 patients who experienced one or more major osteoporotic fractures and were included in the analysis, 1,919 patients experienced a second fracture. According to the International Osteoporosis Foundation, the analysis showed:

  • The risk of a second major osteoporotic fracture after a first increased by 4% for each year of age and was 41% higher for women than men.
  • The risk of a second major osteoporotic fracture was greatest immediately after the first fracture. After that, the risk decreased with time but it remained higher than the non-fracture population risk.


One year after the first major osteoporotic fracture, the risk of a second fracture was three times higher than amongst those who had not experienced a fracture. After 10 years this risk was still elevated, at two times the risk in the non-fracture population.

One of the study authors, Professor Nicholas C. Harvey of the MRC Lifecourse Epidemiology Unit at the University of Southampton, presented the preliminary findings at the recent World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases. He said:

“The results of our study show that the risk of further fracture after a first major osteoporotic fracture is greatest immediately following the first event, with a declining, but still increased, risk in subsequent years. These results suggest that pharmacological treatment for secondary fracture prevention should be considered during the period immediately following a first fracture.”