Low-energy distal radius fractures in middle-aged and elderly men and women—the burden of osteoporosis and fracture risk
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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 ≥50 years should be referred to bone densitometry.
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 ≤ −2.0 or ≤−2.5 standard deviation (SD) and calculate their fracture risk.
A total of 218 men and 1,576 women ≥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®) was applied to calculate the 10-year fracture risk.
T-scores ≤−2.0 and ≤−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 ≤−2.0 SD were 11.6% and 14.5% and for T-score ≤−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.
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 ≥50 years should be referred to bone densitometry, and if indicated, offered medical treatment.
- Low-energy distal radius fractures in middle-aged and elderly men and women—the burden of osteoporosis and fracture risk
Volume 21, Issue 7 , pp 1257-1267
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- Bone densitometry
- Bone mineral density
- Distal radius fractures
- Industry Sectors
- Author Affiliations
- 1. Department of Surgical Sciences, Faculty of Medicine and Dentistry, University of Bergen, 5021, Bergen, Norway
- 2. Department of Rheumatology, Haukeland University Hospital, Bergen, Norway
- 3. Section of Rheumatology, Institute of Medicine, University of Bergen, Bergen, Norway
- 4. Bergen Accident and Emergency Department, University of Bergen, Bergen, Norway
- 5. Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway
- 6. Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
- 7. Department of Rheumatology, Betanien Hospital, Skien, Norway
- 8. Department of Rheumatology, Sørlandet Hospital, Kristiansand, Norway
- 9. Department of Neuroscience, Division of Rheumatology, Norwegian University of Science and Technology, Trondheim, Norway