Low-energy distal radius fractures in middle-aged and elderly men and women--the burden of osteoporosis and fracture risk : A study of 1794 consecutive patients.
One third of 218 men and half of 1,576 women with low-energy distal radius fractures met the bone mineral density (BMD) criteria for osteoporosis treatment. A large proportion of patients with increased fracture risk did not have osteoporosis. Thus, all distal radius fracture patients >or=50 years should be referred to bone densitometry.


BACKGROUND
Main objectives were to determine the prevalence of patients with a low-energy distal radius fracture in need of osteoporosis treatment according to existing guidelines using T-score <or= -2.0 or <or=-2.5 standard deviation (SD) and calculate their fracture risk.


METHODS
A total of 218 men and 1,576 women >or=50 years were included. BMD was assessed by dual energy X-ray absorptiometry (DXA) at femoral neck, total hip, and lumbar spine (L2-L4). The WHO fracture risk assessment tool (FRAX(R)) was applied to calculate the 10-year fracture risk.


RESULTS
T-scores <or=-2.0 and <or=-2.5 SD at femoral neck was found in 37.7% and 19.6% of men and 51.1% and 31.2% of women, respectively. The risk of hip fracture was 6.2% for men and 9.0% for women. The corresponding figures for patients with T-score <or=-2.0 SD were 11.6% and 14.5% and for T-score <or=-2.5 SD 16.3% and 18.2%, respectively. A large proportion of distal radius fracture patients with a high 10-year FRAX risk did not have osteoporosis.


CONCLUSIONS
Every second to every third fracture patient met the present BMD criteria for osteoporosis treatment. Because a large proportion of distal radius fracture patients did not have osteoporosis, treatment decisions should not be based on fracture risk assessment without bone densitometry. Thus, all distal radius fracture patients >or=50 years should be referred to bone densitometry, and if indicated, offered medical treatment.
Øyen
J
J
Department of Surgical Sciences, Faculty of Medicine and Dentistry, University of Bergen, 5021, Bergen, Norway. jannike.oyen@kir.uib.no
Gjesdal
C G
CG
Brudvik
C
C
Hove
L M
LM
Apalset
E M
EM
Gulseth
H C
HC
Haugeberg
G
G
D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000453:epidemiology* / Q000503:physiopathology; D011885:Radius Fractures / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D018570:Risk Assessment / Q000379:methods
D050071:Bone Density Conservation Agents