Table 1 Proposed operational definitions of osteoporotic fractures.
Component (s) | Definition | Methodology | Reference |
|---|---|---|---|
Age | Most fractures in people aged more than 50 years are the result of osteoporosis | Expert opinion | [18] |
Site | "Major" fractures linked to mortality in population-based studies: hip, vertebrae, pelvis, distal femur, proximal tibia, multiple ribs and proximal humerus | Prospective cohort study, Expert consensus based on literature search | [8] [46] |
Mechanism | Fracture caused by injury that would be insufficient to fracture normal bone, i.e. fracture that occurs as a result of minimal trauma (low-energy trauma), such as a fall from standing height or less, or no identifiable trauma. | Expert consensus | [47] |
Bone mineral density (BMD) | BMD value 2.5 standard deviation s(SD) or more below the mean for a young normal population of same sex and race (T-score), at the lumbar, hip or radius site | WHO report based on fracture risk assessment | [48] |
Age, site, bone mineral density | Fractures occurring at a site associated with low BMD and which also increased in incidence after the age of 50 years | 10-year fracture probability calculated from a large cohort | [21] |
Age, sex, race, site | Differential probabilities of attribution to osteoporosis according to the combination of several variables | Expert consensus by the Delphi method | [26] |