title: The effect of osteoporosis on outcomes of operatively treated distal radius fractures.
abstract: OBJECTIVE
  We hypothesized that postmenopausal osteoporotic women with distal radius fractures treated with open reduction internal fixation had worse functional outcomes than women without osteoporosis sustaining similar injuries.
  
  
  METHODS
  We retrospectively reviewed prospectively collected data for 64 postmenopausal women treated with open reduction internal fixation for distal radius fractures between 2006 and 2010 with known bone mineral density measured by dual-energy x-ray absorptiometry at the time of injury (osteopenia, n = 44; osteoporosis, n = 20). Data collected included age, mechanism of injury, fracture severity, and associated comorbidities. Outcomes included range of motion, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and radiographic parameters of fracture reduction. We calculated patients' Charlson Comorbidity Index and tabulated complications. The primary outcome was DASH score at 12 months after injury. We applied multiple linear regression to determine whether bone mineral density status was predictive of functional outcomes 12 months after injury. We used logistic regression analysis to identify factors independently associated with poor outcomes and applied likelihood estimation to determine predictors of a high DASH score at 12 months.
  
  
  RESULTS
  At 1 year postoperatively, women with osteoporosis had average DASH scores 15 points higher than those with osteopenia. Both osteoporosis and the Charlson Comorbidity Index were strong positive independent predictors of higher DASH scores (ie, poorer functional outcomes). There were no significant differences in range of motion or radiographic data between groups. Patients with osteoporosis had a higher rate of major complications.
  
  
  CONCLUSIONS
  Osteoporosis had a negative impact on functional outcomes for women with distal radius fractures treated with open reduction internal fixation. Surgeons should identify high-risk patients, ensure close monitoring, and initiate appropriate preventative measures in this patient population.
  
  
  METHODS
  Prognostic II.
authors.affiliation: Department of Orthopaedic Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: Shannon K
authors.initials: SK
authors.lastname: Fitzpatrick
authors.forename: Natalie E
authors.initials: NE
authors.lastname: Casemyr
authors.forename: David
authors.initials: D
authors.lastname: Zurakowski
authors.forename: Charles S
authors.initials: CS
authors.lastname: Day
authors.forename: Tamara D
authors.initials: TD
authors.lastname: Rozental
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001851:Bone Diseases, Metabolic / Q000453:epidemiology; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology*; D011183:Postoperative Complications; D011446:Prospective Studies; D011885:Radius Fractures / Q000601:surgery*; D012189:Retrospective Studies