<p>Fractures are common in osteoporosis (OP) patients. To discover new biomarkers for reducing the incidence of fractures by taking preventive measures. Hsa_circ_0086004 and hsa-miR-665 were screened using the GEO and starBase databases. Their diagnostic and prognostic value in osteoporotic fractures was evaluated by constructing ROC curves. An osteogenic differentiation medium (OM) was used to induce osteogenic differentiation of human mesenchymal stem cells (hMSCs). Transfected hsa_circ_0086004 plasmid to detect its regulation on hsa-miR-665 and effects on the function of osteoblasts and osteogenic differentiation, and the hsa-miR-665 role in which was determined by transfecting its inhibitor and mimic. Hsa_circ_0086004 was deficient in the serum of OP patients, and its level was further decreased with the occurrence of fractures. Hsa-miR-665 was opposite. Overexpression of hsa_circ_0086004 and inhibition of hsa-miR-665 promoted the growth of osteoblasts and facilitated the osteogenic differentiation of hMSCs. Transfection of hsa_circ_0086004 plasmid significantly decreased the cellular level of hsa-miR-665. The combination of hsa_circ_0086004 and hsa-miR-665 could predict the occurrence and healing of fracture in OP patients, with AUC of 0.907 and 0.902, respectively. Hsa_circ_0086004 may promote fracture healing in OP patients by inhibiting hsa-miR-665, and they are potential biomarkers of OP.</p> Graphical Abstract <p></p>