Oral Presentation ESA-SRB-ANZOS 2025 in conjunction with ENSA

Hip and Vertebral Fractures in Young Adults Presenting to a Large Tertiary Health Service (128282)

Jacqueline Seiffert 1 , Michael Fogarty 1 2 3 , Tung Pham 4 , Bala Krishnamurthy 1 5 , Vivian Grill 1 5 , Hanh H Nguyen 1 5 6 , Madhuni Herath 1 6 7
  1. Endocrinology and Diabetes, Western Health, Melbourne , Victoria, Australia
  2. Endocrinology , Austin Health, Melbourne, Victoria, Australia
  3. Endocrinology and Diabetes, Northern Health, Melbourne, Victoria, Australia
  4. Performance Unit Health Information Services, Western Health, Melbourne, Victoria, Australia
  5. Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
  6. School of Clinical Sciences, Department of Medicine, Monash University , Melbourne, Victoria, Australia
  7. Centre for Endocrinology & Reproductive Health, Hudson Institute of Medical Research , Melbourne , Victoria , Australia

6870699e63bec-Screenshot+2025-07-10+at+9.45.14%E2%80%AFAM.pngMinimal-trauma fractures (MTF) in Young Adults (YA; aged 18–50 years) are uncommon. The associated frailty and long-term impact are under-recognised (1,2). This study characterises YAs presenting with hip and/or vertebral fractures to a tertiary health-network.

YAs presenting with MTF or high-energy fractures (HEF) of the hip or vertebrae to Western Health between January 2016 to December 2023 were identified using ICD-10AM codes. Data including patient demographics, injury-mechanism, comorbidities, medication exposures, bone densitometry results, metabolic bone clinic attendance and osteoporosis therapy were extracted from electronic medical records to be analysed.

86 YAs with hip fractures and 277 with vertebral fractures were eligible for inclusion. MTF predominated (66.3%, 57/86) in YAs with hip fractures (mean age 40.6±7.4, 61.4% males) while only 19.9% (55/277) of vertebral fractures (mean age 38.6±9.1 years, 47.3% males) were MTF. Both hip (77.2%, 44/57) and vertebral (74.5%, 41/55) MTFs had a high prevalence of comorbidites and medication exposures increasing risk for bone loss (Table 1). There were no documented risk factors in 58.6% (17/29) of hip and 70.7% (157/222) of vertebral HEF YAs. Only 29.8% (17/57) of hip MTF YAs and 18.2% (10/55) vertebral MTF YAs had bone densitometry performed, with 58.8% (10/17) and 60% (6/10) demonstrating low bone mass, respectively. There were 11 deaths (9.8% 11/112; 4 hip, 7 vertebral); all occurred in YAs with MTF.

This is the first Australian study to document vertebral MTFs prevalence in YAs and their comorbidities and the second Australian study (3) to highlight the high prevalence of hip MTF in a comorbid population of YAs. This group of YAs with MTF had a high mortality rate, not observed in YAs with HEF. Further research is needed to determine the relationship between MTF and mortality, methods to predict fracture risk in comorbid YAs, and the impact of secondary prevention measures.

  1. Ronnquist SS, Viberg B, Kristensen MT, Palm H, Jensen JE, Madsen CF et al. Frailty and osteoporosis in patients with hip fractures under the age of 60-a prospective cohort of 218 individuals. Otseoporos Int. 2022;(33):1037-1055. DOI: 10.1007/s00198-021-06281
  2. Herath M, Cohen A, Ebeling P, Milat F. Dilemmas in the management of osteoporosis. J Bone Miner Res. 2022 Jan 19;6(1). DOI: 10.1002/jbm4.10594
  3. Wang MT, Yao SH, Wong P, Trinh A, Ebeling PR, Tran T et al. Hip fractures in young adults: a retrospective cross-secondational study of characteristics, injury mechanism, risk factors, complications and follow up. Arch Osteoporos. 2017 May 4. 12(46). DOI: 10.1007/s11657-017-0339-y