Association of osteoporosis with ankle fractures in the geriatric population

Ankle fractures are common in older people. However, their association with osteoporosis remains controversial. This systematic review aims to determine the relationship between ankle fracture and bone mineral density (BMD). The article presents an overview of articles that have statistical data on the relationship of bone mineral density with the frequency of ankle fractures in the elderly. The aim of the review is to define ankle fracture associations in the geriatric population. Search was performed in PubMed, Medline, Scopus publications for articles in which a study of elderly patients with ankle fractures was conducted with an assessment of bone mineral density, followed by statistical processing with the presentation of the results. Ankle fractures in the geriatric population are due to generalized bone loss and changes in trabecular bone microarchitectonics, fragility, and therefore should be considered osteoporotic fractures, regardless of BMD. Correlation relationships were established with female sex, overweight, type 2 diabetes mellitus, arterial hypertension, which are characterized by a decrease in the trabecular structure. The FRAX fracture algorithm underestimates the likelihood of fractures in geriatric patients who have a high BMI and comorbid physical pathology, so it is necessary to focus on independent clinical risk factors for BMD in order to optimize fracture prevention.