Fragility fracture
Also called: low-trauma fracture
What it means
A fragility fracture is a broken bone caused by a fall or bump that normally wouldn't break a healthy bone, often at the hip, spine, or wrist.
Knowing this helps you understand that a DEXA score alone doesn't guarantee safety \u2014 a low-trauma break is itself an important signal about your bone health.
A fragility fracture is a broken bone that happens from a fall or bump that wouldn't normally be expected to cause a fracture — sometimes called a low-trauma fracture. These often happen at the hip, spine, or wrist, and they are a key sign that bone strength has become compromised.
Bone strength isn't just about density. DEXA scans measure bone mineral density as a flat, two-dimensional picture of a three-dimensional structure, so two people with the exact same DEXA score can have very different real-world fracture risk depending on things like bone geometry, cortical thickness, and the internal trabecular architecture. That's an important reason why fragility fractures often happen in people whose DEXA results are labeled 'normal' or 'osteopenic,' not only in those labeled osteoporotic.
Because a DEXA score alone doesn't tell the whole story, a fragility fracture itself is meaningful information about your bone health, separate from the number on a scan. If you've had one, it's worth discussing with your healthcare provider, since they can look at the full picture — your bone density, your health history, and other risk factors — to help figure out next steps.
How sure is this?
Graded Strong Clinical Evidence: Supported by multiple well-designed clinical studies in humans. Read each study with its grade in mind. One study is a piece of the picture, not the whole of it.
Where the Academy teaches it
This page is the short version. The lessons teach it in full, with the context around it and a quiz to lock it in.
Questions people ask about this
Not necessarily — bone density is only part of the picture. A higher density score is a good sign, but fracture risk also depends on bone geometry, cortical thickness, and the internal trabecular architecture, which a density score alone doesn't fully capture. In fact, many fragility fractures happen in people whose scans fall in the normal or osteopenic range.
Read the full answer →Stopping Prolia (denosumab) isn't a neutral event. Because it doesn't build up in your bones the way bisphosphonates do, its protective effect wears off once doses stop. This can lead to a rapid rebound in bone turnover and a risk of multiple vertebral fractures, sometimes within months — so this is a decision to make with your prescriber, not on your own.
Read the full answer →No. A higher bone density score lowers your statistical risk on average, but it doesn't guarantee you won't fracture. Density is only part of what makes bone strong — architecture, bone quality, and your risk of falling all matter too, and many fragility fractures actually happen in people whose scans look normal or only mildly low (osteopenic).
Read the full answer →Related words
A DEXA scan is a low-radiation X-ray test that measures how much mineral is in your hip and spine bones, giving you…
A T-score shows how your bone density compares to a healthy young adult, measured in standard deviations, and it's…
Osteopenia means your bone density, as measured by a DEXA scan, is lower than average but not as low as osteoporosis…
Osteoporosis is a condition where bone breakdown outpaces bone building, causing bones to become thinner, more…
A hip fracture is a break at the femoral neck, the narrow part of bone connecting the hip joint ball to the thigh…
Bone mineral density (BMD) measures how much mineral is packed into your bones, usually estimated with a DEXA scan,…
Education only, not medical advice. Decisions about tests, medications and treatment belong with your own doctor. OsteoStrong does not diagnose, treat or cure any disease.
