Fragility Fracture in a Young Man With Severe Depression, Malnutrition, and Reduced Mobility: A Case Report
Abstract
Fragility fractures in young men are uncommon and should prompt evaluation for underlying pathology. This report describes the case of a 42-year-old male patient who presented with multiple fragility fractures following a low-impact fall in the context of severe depression, alcohol misuse, and prolonged self-neglect. He was underweight (BMI 18 kg/m²), sarcopenic, functionally dependent, and had biochemical evidence of malnutrition. Management was multidisciplinary and involved orthopaedics, dietetics, and psychiatry. Following initiation of venlafaxine, there was a rapid and sustained improvement in mood, appetite, and nutritional intake. This resulted in weight gain and marked functional recovery. The development of refeeding syndrome during treatment further supported the severity of preceding malnutrition. This case highlights the importance of thorough and holistic assessment in patients with unexplained fragility fractures. Early recognition of malnutrition and its underlying drivers may prevent severe systemic complications and improve outcomes.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.