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Rei MOMOMURA　Osteoporosis is an important issue related to life expectancy and healthy life expectancy in Japan, where the super-aging population is growing. Currently, in Japan, some kind of assistance is needed for an average of 10 years at the end of life. In many cases the reason assistance is needed is loss of mobility due to a fracture caused by a fall. When people suffer one fracture due to osteoporosis, they are also more likely to have another fracture, which is called a secondary fracture. Breaking the negative chain of fractures is very important in osteoporosis. In addition, if patients suffer a loss of mobility due to a compression fracture of the spine, this activity cannot be regained even if the fracture is healed. To prevent this from happening, it is also important to heal fractures rapidly, so that patients can quickly return to normal life, thus extending healthy life expectancy.Juntendo Medical Journal2022. 68(1), 31-35Health Topics for TokyoitesBreaking the Chain of Osteoporotic Fractures to Increase Healthy Life ExpectancyIntroductionOsteoporosis is an important life-threatening problem in Japan, where there is a growing super-aging population. Patients with osteoporosis are more likely to suffer fractures, such as osteoporotic vertebral fractures (OVF), proximal femur frac-tures (neck or trochanteric fractures of the femur, PFF), proximal humerus fractures (PHF), and distal radius fractures (DRF) (Figure 1). It has been reported that patients who suffer OVF and PFF in their 60s have a more than ten-fold increased risk of death for up to 2 years1). More specifically, patients who are unable to walk due to a PFF often suffer from various other diseases such as pneumonia, resulting in a 5-year survival rate of 26%. This survival rate is lower than those for liver and stomach cancers. Extending life expec-tancy is the most important theme in medicine, but Key words: osteoporosis, secondary fracture, osteoporotic vertebral fracturesDepartment of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Chiba, JapanCorresponding author: Rei MomomuraDepartment of Orthopaedic Surgery, Juntendo University Urayasu Hospital2-1-1 Tomioka, Urayasu, Chiba 279-0021, JapanTEL: +81-47-353-3111　FAX: +81-47-390-9881　E-mail: rmomomu@juntendo.ac.jp46th Health Topics for Tokyoites “To survive the 100-year life -Aiming for health and longevity-” 〔Held on Feb. 20, 2021〕〔Received　Sep. 12, 2021〕〔Accepted　Sep. 27, 2021〕J-STAGE Advance published date: Nov. 12, 2021Copyright © 2022 The Juntendo Medical Society. This is an open access article distributed under the terms of Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original source is properly credited. doi: 10.14789/jmj.JMJ21-0025-Rwe believe that extending healthy life expectancy is just as important. Currently, in Japan, people need some help for an average of 10 years at the end of life, and the reason for needing assistance is more often immobility due to musculoskeletal disorders than weakness due to dementia or old age. In this context, the Japanese Orthopaedic Association (JOA) proposed the term ‘locomotive syndrome’ to designate a condition requiring nursing care or the risk of developing such a condition, following a decline in mobility resulting from one or more disorders of the locomotive organs, which include the bones, joints, muscles, and nerves2). Even if such support is needed, it is expected that there will be a shortage of manpower in Japan, where one in three people will be 65 or older in 2030. Therefore, we must do all we can to prevent fractures and immobility.31Osteoporosis and Osteoporotic Vertebral Fractures: