Objective To investigate the incidence of osteoporotic fractures (OF) in women aged 40 to 60 years in 10 years, analyze the trend of OF risk before and after 10 years using FRAX software and assess the application value of FRAX.

Methods A total of 422 women aged 40～60 years with bone mineral density (BMD) examination in 2011 were selected as the subjects. The BMD was remeasured, and the questionnaire was conducted. The 10-year probability of major osteoporotic fractures (MOFP) (vertebral, hip, forearm or proximal humerus) and 10-year probability of hip osteoporotic fractures (HOFP) were calculated using FRAX software. The changes of MOFP and HOFP were compared before and after 10 years.

Results A total of 299 patients were followed up, 14 cases (4.7%) developed osteoporotic fractures within 10 years. Compared with 10 years ago, the 10-year MOFP and 10-year HOFP of different age groups significantly increased (P ＜ 0.01). The 10-year MOFP increased the most in the 46–50 group and the 10-year HOFP increased the most in the 56–60 group. In addition, the proportion of high-risk HOFP patients at 10 years increased significantly (P ＜ 0.01), while the proportion of high-risk MOFP patients at 10 years did not change significantly (P ＞ 0.05).

Conclusions The actual risk of fracture within 10 years in women aged 40 to 60 years is significantly higher than that calculated by FRAX, and the risk of osteoporotic fracture after 10 years is significantly higher, which should be paid attention to. FRAX has predictive value for fracture risk, but has the potential to underestimate fracture risk, especially at major fracture sites.