Fragility Fracture in a Young Man With Severe Depression, Malnutrition, and Reduced Mobility: A Case Report.

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.