The epidemiology of fracture: Why treatment matters

Osteoporosis is a skeletal disorder characterised by low bone mass and microarchitectural deterioration of bone tissue with a consequent increase in the fragility of bone and consequent susceptibility to fracture. The fractures most commonly reported are those of the proximal femur, distal radius and vertebra, but fractures at other sites such as the pelvis, proximal humerus, and proximal tibia, also show similar patterns. These fractures are the serious and important outcomes of the condition and lead to severe mortality and morbidity, a significant burden on society in general and a huge impact economically. Fracture rates vary by age and geography; absolute numbers are expected to rise in subsequent generations despite stabilisation of fracture rates due to demographic population changes. Clustering of fractures is commonly described and may help in the identification of those individuals at highest risk who would benefit most from therapy. This chapter will review the epidemiology of fragility fractures, and highlight the importance of fracture at a personal and societal level.