The assessment of fracture risk often relies primarily on measuring bone mineral density, thereby accounting for only a single pathology: the loss of bone mass. However, bone’s ability to resist fracture is a result of its biphasic composition and hierarchical structure that imbue it with high strength and toughness.
https://www.ncbi.nlm.nih.gov/pubmed/27021150
Bone. 2016 Jun;87:37-43. doi: 10.1016/j.bone.2016.03.013. Epub 2016 Mar 26.