Low BMD is a risk factor for low-energy Colles' fractures in women before and after menopause.
Until now, it was unclear if low volumetric bone mineral density at the distal radius was also a risk factor for Colles' fracture, especially in patients with low-energy trauma. In our study, we used peripheral quantitative computed tomography to measure volumetric bone mineral density of a nonfractured distal radius and dual-energy x ray absorptiometry to measure areal bone mineral density at the spine and hip in patients with Colles' fractures, including 45 women who were premenopausal (age range, 40-50 years) and 39 women who were postmenopausal (age range, 51-65 years). In each group, the patients were subdivided into low-energy and high-energy fracture groups. Ninety-five age-matched healthy women who were premenopausal and 90 age-matched healthy women who were postmenopausal without fracture history served as controls. The results showed that patients with low-energy fractures had a lower bone mineral density at all measurement sites, compared with either patients with high-energy fractures or control subjects. More patients were found with a bone mineral density less than -2.5 standard deviations (Z-score) in the premenopausal group (12.5% measured by dual-energy x ray absorptiometry and 41.2% measured by peripheral quantitative computed tomography) than in the postmenopausal group (6.0% measured by dual-energy x ray absorptiometry and 4.8% measured by peripheral quantitative computed tomography). These results suggest that low bone mineral density, particularly measured using peripheral quantitative computed tomography at the distal radius of women who were premenopausal, was an important risk factor for low-energy Colles' fractures.


METHODS
Prognostic study, Level I-1 (prospective study). See the Guidelines for Authors for a complete description of levels of evidence.
Hung
Leung Kim
LK
Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, P.R. China.
Wu
Hay Tong
HT
Leung
Ping Chung
PC
Qin
Ling
L
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015519:Bone Density; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003100:Colles' Fracture / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D015663:Osteoporosis, Postmenopausal / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D012307:Risk Factors; D014057:Tomography, X-Ray Computed