Osteoporosis International

, Volume 21, Issue 7, pp 1257–1267

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
  • J. Øyen
  • C. G. Gjesdal
  • C. Brudvik
  • L. M. Hove
  • E. M. Apalset
  • H. C. Gulseth
  • G. Haugeberg
Original Article

DOI: 10.1007/s00198-009-1068-x

Cite this article as:
Øyen, J., Gjesdal, C.G., Brudvik, C. et al. Osteoporos Int (2010) 21: 1257. doi:10.1007/s00198-009-1068-x

Abstract

Summary

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.

Introduction

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.

Methods

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.

Results

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.

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 ≥50 years should be referred to bone densitometry, and if indicated, offered medical treatment.

Keywords

Bone densitometryBone mineral densityDistal radius fracturesFRAX®NorwayOsteoporosis

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2009

Authors and Affiliations

  • J. Øyen
    • 1
  • C. G. Gjesdal
    • 2
    • 3
  • C. Brudvik
    • 1
    • 4
  • L. M. Hove
    • 1
    • 5
  • E. M. Apalset
    • 2
    • 6
  • H. C. Gulseth
    • 7
  • G. Haugeberg
    • 8
    • 9
  1. 1.Department of Surgical Sciences, Faculty of Medicine and DentistryUniversity of BergenBergenNorway
  2. 2.Department of RheumatologyHaukeland University HospitalBergenNorway
  3. 3.Section of Rheumatology, Institute of MedicineUniversity of BergenBergenNorway
  4. 4.Bergen Accident and Emergency DepartmentUniversity of BergenBergenNorway
  5. 5.Department of Orthopedic SurgeryHaukeland University HospitalBergenNorway
  6. 6.Department of Public Health and Primary Health CareUniversity of BergenBergenNorway
  7. 7.Department of RheumatologyBetanien HospitalSkienNorway
  8. 8.Department of RheumatologySørlandet HospitalKristiansandNorway
  9. 9.Department of Neuroscience, Division of RheumatologyNorwegian University of Science and TechnologyTrondheimNorway