Epidemiology of Fractures

There is increasing awareness that osteoporosis in men is an important public health issue. The main clinical consequence of osteoporosis, be it in men or women, is a fracture. Osteoporotic fractures in general, but particularly of the hip, are associated with considerable morbidity and mortality, which appear to be worse for men than women. It is important to note that not all fractures in men are related to osteoporosis. Fractures at certain bone sites appear to be more likely to be secondary to bone fragility than others. Furthermore, fracture incidence in men relates not only to diminished bone strength as seen in osteoporosis, but also to frequency of exposure to trauma of sufficient force which can result in fracture, irrespective of bone strength. In fact, the differences in fracture incidence observed between men and women, as well as between men from various racial/ethnic backgrounds or geographic locations, may relate not only to bone strength but also to trauma exposure. This chapter reviews the epidemiology of fractures in men with particular distinction between overall and osteoporotic fractures, as well as differences, where applicable, between men and women, races/ethnicity and geographic locations which, together, may provide additional insights into the pathogenesis of osteoporotic fractures in men.