Fragility Fracture Decision Aid

For shared-decision making

This interactive tool aids primary care practitioners and patients to determine risk of
fragility fractures Fragility fractures are bone breaks from a normal activity, or from a minor incident or fall that would not cause a bone to break in a healthy adult. Most common types of these breaks are hip and spine fractures.
and discuss treatment options and benefits. For the CTFPHC full recommendations for fragility fractures screening, click here or visit the Resources tab.

 

Calculate Risk This tool uses the FRAX® algorithm to calculate risk. For more information, Click here

What is my risk of breaking a bone?

( * Indicates required field)

Choose an option: Please use the Risk Info option to calculate the FRAX Score.

Please use the FRAX Score option if you already know the FRAX Score.

Age
The Task Force does not recommend screening for females under 65 years. For more information please see our guideline.
Sex
Sex assigned at birth.
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The Task Force does not recommend screening for males. For more information please see our guideline.
Weight (kg)
For unit conversions, please refer to this calculator.
Height (cm)
For unit conversions, please refer to this calculator.
Previous Fracture
A bone breakage in adult life occurring spontaneously, or from an incident that would not cause a bone to break in a healthy adult.
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Parent Fractured Hip
History of hip fracture in the patient's mother or father.
Current Smoker
Patient currently smokes tobacco.
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Glucocorticoids
Enter yes if the patient is currently taking or has previously taken oral glucocorticoids for more than 3 months at a dose of prednisolone of 5mg daily or more (or equivalent doses of other glucocorticoids).
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Rheumatoid Arthritis
Patient has a confirmed diagnosis of rheumatoid arthritis (RA).
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Secondary osteoporosis
Patient has a disorder strongly associated with osteoporosis.
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Alcohol 3 or more units/day
For this calculation, a unit of alcohol is equivalent to 285ml of beer (equivalent to 0.8 Canadian unit), a 30ml measure of spirits (equivalent to 0.7 Canadian unit), or a 120ml of wine (equivalent 0.8 Canadian unit).
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Femoral Neck BMD (T-score or g/cm2) (if available)
Please enter the T-score based on the NHANES III female reference data. Alternatively select the make of DXA scanning equipment used and then enter the actual femoral neck BMD (in g/cm2).
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BMD is NOT required for initial risk assessment

(e.g., -2.5)

Risk

Risk over 10 years

 

 

Interventions

Select treatment option

Please note: exercise, falls prevention, and nutrition are vital and important measures. Information in this section is only about pharmacological options.

Bisphosphonates

 

 
 

Summary of CTFPHC Recommendations

Screening may help reduce the risk of fragility fractures in females over 65 years. The CTFPHC recommends “risk assessment-first” screening for females aged ≥ 65 years as follows:

  • Use the Canadian clinical FRAX risk assessment tool results to facilitate a discussion on preventive medication. At this initial assessment, bone mineral density (BMD) measurement is not required.
  • After this discussion, if preventive medication is being considered, perform BMD measurement. Then re-calculate fracture risk by adding the BMD T-score into FRAX.

Screening is not recommended for females under 65 years or for males.

These recommendations do not apply to those already on preventive medication.

For further information, please visit www.canadiantaskforce.ca