What Is a Fragility Fracture?

A fragility fracture is a broken bone that results from an impact that would not normally break a healthy bone. It might be a fall from standing height, a trip, a minor bump — or in some cases, no obvious injury at all, such as a fracture that occurs simply from coughing, sneezing, or bending forward.

The Most Common Sites

Fragility fractures can occur anywhere in the body, but they are most common at four sites:

How Do Fragility Fractures Relate to Osteoporosis?

Fragility fractures are a direct consequence of osteoporosis — bones that have lost density and strength are far more likely to break under forces that a healthy bone would withstand. In many cases, a fragility fracture is the first indication that a person has osteoporosis.

Importantly, a first fragility fracture dramatically increases the risk of a second. Research shows that someone who has had one vertebral fracture has a five-fold increased risk of another vertebral fracture within the following year. A wrist fracture approximately doubles the risk of a subsequent hip fracture. This is sometimes called the “fracture cascade”.

This is why every fragility fracture should be taken seriously as a medical event — not just treated in isolation, but used as a prompt to assess bone density and start appropriate treatment or prevention.

Why Are Fragility Fractures Serious?

The consequences of fragility fractures go far beyond the fracture itself:

• Loss of independence: Hip fractures, in particular, can result in permanent loss of mobility and the ability to live independently.
• Mortality: In Ireland, up to 20–30% of people who sustain a hip fracture die within 12 months of their fracture.
• Chronic pain: Vertebral fractures often result in persistent back pain and can cause a stooped posture (kyphosis).
• Fear of falling: After a fracture, many people become fearful of falling, which leads to reduced activity, further muscle weakness, and even higher fall risk.
• Hospital and care costs: Osteoporotic fractures are a major burden on the Irish healthcare system, with hip fractures alone requiring lengthy hospital stays and rehabilitation.

When Should I Seek Help?

You should see your GP promptly if:

• You have had a fracture from a low-energy impact (a fall from standing height or less)
• You are over 50 and have broken your wrist, hip, or spine
• You have persistent back pain, especially if you have noticed a loss of height or a stooped posture
• You have several risk factors for osteoporosis and have never had a bone density test

Your GP can arrange a DXA scan to assess your bone density and advise on treatment or prevention.

Secondary Fracture Prevention

After a fragility fracture, the priority is to prevent a second one. In Ireland, Fracture Liaison Services (FLS) exist in many hospitals to identify people who have had fractures and ensure they receive appropriate assessment and treatment. If you have had a fracture, ask your hospital team or GP whether a Fracture Liaison Service is available to you.

More information is available on our Secondary Fracture Prevention page.