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Step 1
 Fracture : is a complete or incomplete break
in a bone resulting from the application of
excessive force
 Diet : food and drink considered in terms of

its qualities, composition, and its effects on

Step 2
 1. what is the etiologi of this scenario ?
 2. what is the management of this scenario ?
 3. what is the risk factor of this scenario ?
Step 3
 The most common cause of osteoporosis arises from
oestrogen deficiency that begins some years before
the time of menopause. The skeleton comprises
approximately 20% trabecular bone and 80% cortical
bone and undergoes a continual process of
resorption and formation, governed by the activity of
bone cells in bone remodelling units.3 Approximately
10% of the adult skeleton is remodelled every year.
Oestrogen deficiency accelerates the normal turnover
of bone tissue, but the net activity of bone resorbing
cells (osteoclasts) is greater than that of bone
forming cells (osteoblasts).
2. Management
 Acute Fracture
The management of acute fracture is not
different from that of a non-osteoporotic
fracture. It is important to restore mobility as
soon as possible since immobilisation is an
important cause of bone loss.
 Lifestyle Advice
This includes adequate intakes of protein,
calcium and vitamin D. Intakes of 1000
mg/day of calcium, 800 IU of vitamin D and
of 1 g/kg body weight of protein are
recommended. Smoking and high intakes of
alcohol are recognised risk factors for
fractures and are to be avoided. Many
fractures occur after a fall and strategies for
the avoidance of falls should be considered.
 Assessment of Fracture Risk
The longer term management of
osteoporosis requires the assessment of
future fracture risk which, in turn, determines
the need for intervention. At present there is
no accepted policy for population screening
in the UK to identify individuals with
osteoporosis or those at high risk of fracture.
3. Clinical risk factors used for the
assessment of fracture probability
 Age
 Sex

 Low body mass index (≤19kg/m2)

 Previous fragility fracture, particularly of the hip, wrist

 and spine including

 morphometric vertebral fracture

 Parental history of hip fracture

 Current glucocorticoid treatment (any dose, by mouth

 for 3 months or more)

 Current smoking

 Alcohol intake of 3 or more units daily

 So that play a role in the occurrence of osteoporosis
directly is the number and activity of cells osteoclast
to absorb the bones influenced by
mediatormediator, that which is affected by the
onset of mediator-mediator levels of estrogen.
 Sport is really an important part on is prevention

and treatment of the osteoporosis.Sports program

for patients osteoporosis very different to sport for
prevention osteoporosis. Kind of a good sport is
with the imposition and exercise plus strength
training muscle that is tailored to the age and
circumstances of each individual.