Abstract
There is increasing evidence that fracture risk in osteoporosis is not only related to bone mineral density but also to a compilation of factors that are often referred to under the legendary terminology “bone quality”. This article reviews initially the biomechanical aspects of trauma and then the current understanding of the many characteristics of bone that give it strength to resist trauma, including those characteristics that can currently be measured in vivo, those that will shortly be assessable, and those that yet defy measurement in the intact human. The mechanism by which antiresorptive and anabolic therapies for osteoporosis may affect bone strength are also discussed.
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