Review steroids, vitamin D/calcium intake, falls, puberty/growth and bone surveillance with the clinic. New pain or loss of function after a fall warrants fracture evaluation.
What this means in real life
Fracture prevention in DMD combines bone surveillance, fall reduction, nutrition, steroid management and rapid evaluation of pain. Long-term corticosteroids, reduced weight-bearing, delayed puberty and vitamin D deficiency can weaken bone. Vertebral fractures may be silent or appear as back pain or height loss, while long-bone fractures can cause abrupt loss of walking.
Ask the DMD bone/endocrine team about vitamin D testing, calcium intake from diet, growth and puberty, spine imaging and DEXA interpretation. DEXA alone can underestimate or misrepresent risk in a short child and should be interpreted by clinicians familiar with pediatric DMD. Bisphosphonate decisions depend on fractures, symptoms and specialist assessment.
At home and school, reduce rushed stairs, unsafe transfers and clutter, use appropriate mobility for distance and train caregivers. New back or limb pain after a fall needs prompt evaluation even when swelling is minimal.
A practical checklist
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Review vitamin D, calcium intake, growth, puberty and fracture history.
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Ask about vertebral imaging—not only DEXA.
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Use safe transfers and mobility to reduce preventable falls.
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Evaluate new pain or functional loss promptly.
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Create a post-fracture rehab plan aimed at preserving prior function when possible.
Questions to bring with you
Use these at the clinic, school meeting, equipment evaluation, program interview or benefits call. Write down the answers and who owns the next step.
- What bone surveillance is due now?
- Has height or back shape changed?
- How should DEXA be adjusted for body size?
- Would a vertebral or long-bone fracture change treatment?
- Which activities and transfers carry the greatest risk?
Important context
Individual needs, eligibility and safety can differ. Confirm the plan with the relevant Duchenne-experienced clinician, therapist, school team or program before acting.
Sources used for this guide
Direct links are included so families can check the original guidance and bring it to qualified professionals.
Content review: July 18, 2026. Medical labels, trials, benefits and programs can change after publication.
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