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

Authors

    • Department of Surgical Sciences, Faculty of Medicine and DentistryUniversity of Bergen
  • C. G. Gjesdal
    • Department of RheumatologyHaukeland University Hospital
    • Section of Rheumatology, Institute of MedicineUniversity of Bergen
  • C. Brudvik
    • Department of Surgical Sciences, Faculty of Medicine and DentistryUniversity of Bergen
    • Bergen Accident and Emergency DepartmentUniversity of Bergen
  • L. M. Hove
    • Department of Surgical Sciences, Faculty of Medicine and DentistryUniversity of Bergen
    • Department of Orthopedic SurgeryHaukeland University Hospital
  • E. M. Apalset
    • Department of RheumatologyHaukeland University Hospital
    • Department of Public Health and Primary Health CareUniversity of Bergen
  • H. C. Gulseth
    • Department of RheumatologyBetanien Hospital
  • G. Haugeberg
    • Department of RheumatologySørlandet Hospital
    • Department of Neuroscience, Division of RheumatologyNorwegian University of Science and Technology
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