Bone microdamage and skeletal fragility in osteoporotic and stress fractures

David B. Burr, Mark R. Forwood, David P Fyhrie, R. Bruce Martin, Mitchell B. Schaffler, Charles H. Turner

Research output: Contribution to journalArticlepeer-review

544 Scopus citations


The accumulation of bone microdamage has been proposed as one factor that contributes to increased skeletal fragility with age and that may increase the risk for fracture in older women. This paper reviews the current status and understanding of microdamage physiology and its importance to skeletal fragility. Several questions are addressed: Does microdamage exist in vivo in bone? If it does, does it impair bone quality? Does microdamage accumulate with age, and is the accumulation of damage with age sufficient to cause a fracture? The nature of the damage repair mechanism is reviewed, and it is proposed that osteoporotic fracture may be a consequence of a positive feedback between damage accumulation and the increased remodeling space associated with repair.

Original languageEnglish (US)
Pages (from-to)6-15
Number of pages10
JournalJournal of Bone and Mineral Research
Issue number1
StatePublished - 1997
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


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