title: Risk of hip fracture following a wrist fracture-A meta-analysis.
abstract: OBJECTIVE
  This purpose of this meta analysis was to investigate and quantify the relative risk of hip fracture in patients who have sustained a wrist fracture.
  
  
  METHODS
  Studies were identified by searching Medline, Embase, Cochrane CENTRAL database and CINAHL from their inception to August 2015. Studies reporting confirmed hip fracture following wrist fracture were included. Data extraction was carried out using a modified Cochrane data collection form by two reviewers independently. Quality assessment was carried out using a modified Coleman score and the Newcastle Ottawa scale for cohort studies. An assessment of bias was performed for each study using a modified Cochrane Risk of Bias tool. A pooled relative risk(RR) was estimated with 95% CI from the RR/HRs and CIs reported in the studies.
  
  
  RESULTS
  12 studies were included in the final meta-analysis (4 male, 8 female only). Relative risk of hip fracture following wrist fracture for women was 1.43 (CI 1.27 to 1.60). In men it was not significantly increased (RR 2.11, 95% CI: 0.93-4.85). Heterogeneity was low (I squared 0%) for both groups so a fixed effects model was used.
  
  
  CONCLUSIONS
  Risk of a subsequent hip fracture is increased for women who suffer a wrist fracture (RR 1.43). Resources and preventative measures should be targeted towards these high risk patients to prevent the catastrophic event of a hip fracture. This meta analysis confirms and quantifies the increased relative risk of hip fracture after wrist fracture in women.
authors.affiliation: University Hospitals of Leicester, UK. Electronic address: Nickjnajohnson@yahoo.co.uk.
authors.forename: Nick A
authors.initials: NA
authors.lastname: Johnson
authors.affiliation: University Hospitals of Leicester, UK.
authors.forename: E R B
authors.initials: ER
authors.lastname: Stirling
authors.affiliation: University Hospitals of Leicester, UK.
authors.forename: P
authors.initials: P
authors.lastname: Divall
authors.affiliation: University Hospitals of Leicester, UK.
authors.forename: J R
authors.initials: JR
authors.lastname: Thompson
authors.affiliation: University Hospitals of Leicester, UK.
authors.forename: A S
authors.initials: AS
authors.lastname: Ullah
authors.affiliation: University Hospitals of Leicester, UK.
authors.forename: J J
authors.initials: JJ
authors.lastname: Dias
mesh_terms: D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use; D006620:Hip Fractures / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy / Q000453:epidemiology*; D058866:Osteoporotic Fractures / Q000453:epidemiology*; D011885:Radius Fractures / Q000453:epidemiology*; D018570:Risk Assessment; D017678:Sex Distribution; D014458:Ulna Fractures / Q000453:epidemiology*; D006113:United Kingdom / Q000453:epidemiology; D014954:Wrist Injuries / Q000453:epidemiology*
chemical_list: D050071:Bone Density Conservation Agents
keywords: Fragility fracture; Hip fractures; Osteoporosis; Wrist fracture