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To the Editor: We have comments regarding the study of high-trauma fractures and low bone mineral density in older women and men by Ms Mackey and colleagues.¹ First, it appears that the majority of high-trauma fractures described were due to rather minimal trauma, given that 37.7% of patients in the Study of Osteoporotic Fractures (SOF) cohort and 51.1% in the Osteoporotic Fractures in Men Study (MrOS) cohort sustained fracture due to a fall from more than standing height. This could have contributed to the positive association of osteoporosis with high trauma.

It would be helpful to know whether any persons sustained a low-trauma fracture after a high-trauma fracture or vice versa. This would give more information about underlying osteoporosis, rather than the intensity of trauma, as a cause of increased risk of fracture. Also, fracture at any site would increase the predisposition to further fracture by other mechanisms such as . . . [Full Text of this Article]

Hari Kumar K. V. S., MD
hariendo@rediffmail.com

Abhyuday Verma, MD
Department of Endocrinology
Medwin Hospitals
Nampally, Hyderabad, India

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