Bone Fracture by Ray Sahelian, M.D.

A bone fracture is a medical condition in which a bone is damaged. The fracture could be aligned or displaced. A bone fracture often occurs as a result of trauma. A bone fracture can also occur as a result of certain medical conditions that weaken the bones, such as osteoporosis or as a consequence of certain types of cancer that have metastasized to bone. A broken bone is defined as a complete severing of the bone, as in opposition to a fracture covering any type of crack or break in the bone.

Preventing bone fracture with calcium and vitamin D supplements
Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis.
Lancet. 2007 Aug 25;370(9588):657-66. Centre for Complementary Medicine Research, University of Western Sydney, New South Wales, Australia.
Whether calcium supplementation can reduce osteoporotic fractures is uncertain. We did a meta-analysis to include all the randomised trials in which calcium, or calcium in combination with vitamin D, was used to prevent fracture and osteoporotic bone loss. We identified 29 randomised trials that recruited people aged 50 years or older were eligible. In trials that reported fracture as an outcome, treatment was associated with a 12% risk reduction in fractures of all types. In trials that reported bone-mineral density as an outcome, the treatment was associated with a reduced rate of bone loss of 0.54% at the hip and 1.19% in the spine. The bone fracture risk reduction was significantly greater in trials in which the compliance rate was high. The treatment effect was better with calcium doses of 1200 mg or more than with doses less than 1200 mg, and with vitamin D doses of 800 IU or more than with doses less than 800 IU. Evidence supports the use of calcium, or calcium in combination with vitamin D supplementation, in the preventive treatment of bone fracture in people aged 50 years or older.

Ankle fracture treatment
For treatment of ankle fractures in children, a removable ankle brace allows earlier return of physical function than casting, and is more cost-effective. The thigh contains one bone, the femur, while the leg contains two bones, the fibula and the tibia. The fibula runs along the outer part of the leg and a fracture in the "distal" region means that the bone is broken at the ankle. Distal fibular ankle fractures in children are stable and pose little risk, but they are usually referred to orthopedic care and immobilized with a cast for 3 to 4 weeks. Dr. Kathy Boutis and colleagues at the University of Toronto explain, "The convenience and efficiency of the brace may reduce costs, avoid ER visits for patients who receive a diagnosis of the injuries in a primary care setting, reduce time spent in the ER, and obviate the need for follow-up visits in busy general or pediatric orthopedic clinics." Pediatrics, June 2007.

Hip fracture
Men and women with diabetes, either type 1 or type 2, are more likely than the general population to bone fracture a hip.

Drugs that increase the risk for bone fracture
Two drugs prescribed by doctors to lower blood sugar and treat diabetes -- pioglitazone and rosiglitazone -- increase the risk of bone fractures. Patients who use pioglitazone and rosiglitazone drugs for a year or longer are more than twice as likely as nonusers to sustain a bone fracture. Pioglitazone and rosiglitazone, also known by the trade names Actos and Avandia, respectively, belong to a drug class called thiazolidinediones. The use of pioglitazone and rosiglitazone is most strongly linked to bone fractures of the hip and wrist, and the elevated risk is seen in both men and women, independent of age. Archives of Internal Medicine, April 28, 2008.