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Invited Commentary
June 7, 2021

A Distinction Without a Difference—Does It Matter Whether Fractures Are Nontraumatic or Traumatic?

Author Affiliations
  • 1Endocrine Research Unit, San Francisco Veterans Affairs Health Care System, San Francisco, California
  • 2Department of Medicine, University of California, San Francisco
JAMA Intern Med. Published online June 7, 2021. doi:10.1001/jamainternmed.2021.2599

“A 54-year-old woman presents with a hip fracture after a fall from standing.”

“A 70-year-old woman presents with a fracture of the radius after a fall from a 6-foot ladder.”

“A 64-year-old woman presents with fractures of her pelvis and tibia after a high-speed motor vehicle collision.”

In approaching a patient who has fractured a bone, clinicians are trained to detail the circumstances of the fracture. Was it the result of a ground-level fall or a higher level of trauma? We do this because we believe that the fracture sustained after minimal or no trauma constitutes a fragility fracture and that fragility fractures are the only ones that warrant evaluation and interventions to prevent future fracture. Clinical practice guidelines reinforce this behavior.1

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