Postmenopausal women with an initial bone fracture, even in the arm or wrist, have a three to six times higher risk for subsequent bone fractures, according to a study published online May 5 in EClinicalMedicine.
Carolyn J. Crandall, M.D., from the University of California, Los Angeles, and colleagues assessed subsequent fractures after initial fracture among participants in the Women’s Health Initiative (1993 to 2018). The analysis included 47,458 participants with incident fracture (baseline age, 50 to 79 years) with a mean of 15.4 years of follow-up.
The researchers found that the risk for each type of subsequent fracture was increased after each type of initial fracture. Following an incident lower arm/wrist fracture, there was a significant association with elevated risks for subsequent fractures at the upper arm/shoulder, upper leg, knee, lower leg/ankle, hip/pelvis, and spine (adjusted hazard ratios [aHRs] range, 2.63 to 5.68). After an initial lower arm or wrist fracture, the risk for hip fracture increased (aHR, 4.80). Similar results were seen following an initial upper arm or shoulder fracture (aHR, 5.06), initial upper leg fracture (aHR, 5.11), initial knee fracture (aHR, 5.03), initial lower leg/ankle fracture (aHR, 4.10), and initial spine fracture (aHR, 6.69). All age groups showed significant associations, with subsequent fracture risk more pronounced among non-Hispanic Black, Hispanic/Latina, and Asian/Pacific Islander women versus non-Hispanic White women.
“Women who experience any of these fractures should be targeted for interventions to prevent subsequent fractures,” the authors write.