Important: This page provides general information only. It is not a substitute for professional medical advice, diagnosis, or treatment. If you have concerns about your bone health, please speak to your GP.
After a Fracture: What Next?
Experiencing a fragility fracture is a significant health event. Beyond treating the fracture itself, the most important thing to happen next is a thorough assessment of your bone health and a plan to prevent a second fracture. Unfortunately, this does not always happen automatically — so knowing what to ask for is essential.
Critical window: The period immediately following a fracture is associated with the highest risk of a second fracture — this has been termed the “imminent fracture risk” period. Research suggests that the risk of a subsequent fracture is highest in the first year after a fracture, and that early treatment intervention provides the greatest benefit in this window.
Immediate Steps After a Fracture
Get appropriate medical treatment for the fracture
Whether that is surgery (for hip fractures), a cast (for wrist fractures), or pain management and physiotherapy (for spinal fractures) — treating the fracture itself is the immediate priority.
Ask about bone density assessment
While in hospital or at your GP, ask: 'Was this fracture caused by osteoporosis? Should I have a bone density scan if I haven't had one?' A DXA scan should be arranged if it has not been done recently.
Ask about Fracture Liaison Service referral
Many Irish hospitals have a Fracture Liaison Service (FLS) — a specialist team that coordinates bone health assessment and secondary prevention after a fracture. Ask your hospital team or GP if an FLS is available and whether you can be referred.
Discuss bone-protective medication
If you have osteoporosis (confirmed or suspected), the evidence for starting bone-protective medication promptly after a fracture is strong. Treatment should ideally be started before hospital discharge or at the first GP visit afterwards.
Ensure calcium and Vitamin D
Adequate calcium and Vitamin D are essential alongside any medication. If you are not already taking these, discuss with your GP or hospital team.
Address fall risk
Ask for referral to a physiotherapist for rehabilitation and falls prevention. Consider an occupational therapy assessment of your home environment. See our Falls Prevention page for practical steps.
The Imminent Fracture Risk Period
One of the most important recent developments in osteoporosis management is the recognition of “imminent fracture risk” — the sharply elevated probability of a second fracture in the weeks and months immediately following an initial fracture. Research has shown that:
- Risk of a second fracture is highest in the first year after a first fracture
- Risk of a hip fracture is particularly elevated in the 3–6 months following a vertebral fracture
- Treatment started promptly after the first fracture provides the greatest reduction in subsequent fracture risk
- Some international guidelines now recommend starting anabolic (bone-building) therapy during this high-risk period rather than waiting for bisphosphonate effects
This is why prompt action after a fracture matters so much — the sooner treatment begins, the greater the reduction in risk during this critical window.
Bone Density Testing After a Fracture
If you have had a fragility fracture and not previously had a DXA scan, one should be arranged. The DXA scan helps:
- Confirm the diagnosis of osteoporosis and its severity
- Provide a baseline for monitoring treatment response
- Help determine which treatment is most appropriate
- Provide information on whether other family members should be assessed
If you have previously had a DXA scan that showed osteopenia but not osteoporosis, and you have now had a fragility fracture, the fracture itself changes your classification to “established osteoporosis” regardless of your T-score — and treatment is strongly recommended.
Advocating for Yourself
Studies consistently show that the majority of people who sustain fragility fractures do not receive appropriate bone health assessment or treatment afterwards. You may need to advocate for yourself or a family member. Key questions to ask:
- “Is this a fragility fracture related to osteoporosis?”
- “Should I have a bone density scan?”
- “What medication should I take to prevent another fracture?”
- “Is there a Fracture Liaison Service I can be referred to?”
- “What falls prevention steps should I take?”
If you feel your concerns are not being addressed, it is appropriate to seek a second opinion, ask for a specialist referral (rheumatologist, endocrinologist, or metabolic bone disease clinic), or contact the Irish Osteoporosis Society for guidance.
Talk to Your GP
After any fragility fracture, speak to your GP or hospital team about bone density assessment and secondary fracture prevention. Do not leave the hospital without asking about this.
You can say: “I'd like to discuss my bone health and whether I should have a DXA scan.”
Questions to Ask Your DoctorLast reviewed: February 2026 — FragilityFracture.ie Editorial Team