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Bone Mineral Density is Not Correlated with One-Year Functional Outcome in Distal Radial Fractures: A Preliminary Study

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction:

The intrinsic stability of fractures related to soft tissue injury and the comminution of the metaphyseal part of the distal radius influence the chance of secondary displacement in distal radial fractures treated conservatively. A low bone mineral density may also contribute to this secondary displacement and could therefore play a role in functional outcome. This possible relation between functional outcome and bone mineral density is poorly studied.

Patients and Methods:

Patients with a unilateral conservatively treated distal radial fracture were assessed one year after their fracture with the DASH score (disabilities of the arm, shoulder and hand) and the Cooney score. Fractures were classified according to the AO classification. Radial inclination, radial shift, radial tilt and ulnar variance were measured on the first and follow-up radiographies. Bone mineral densities of both the hip and lumbar spine were measured by DXA and expressed as T-scores.

Results:

Fifty-four patients participated in this study (mean age 68 years). Osteoporosis (T-score ≤ –2.5) was present in 20 patients (37%), osteopenia (T-score of –1 to –2.5) in 30 patients (56%), and normal bone density (T-score > –1) in four patients (7%). The distribution of fracture types according to the AO classification showed 32 A-type fractures, eight B-type fractures and 14 C-type fractures. Both univariate linear and multivariate regression analysis with covariates of age, sex, body mass index and AO classification showed no significant correlation between T-score and functional outcome.

Conclusion:

The functional outcome of conservatively treated distal radial fractures in this study does not correlate with bone mineral density. Therefore, BMD measurement cannot be used to predict functional outcome in these patients.

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References

  1. Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury 2006;37:691–7.

    Article  PubMed  Google Scholar 

  2. van Staa TP, Dennison EM, Leufkens HG, Cooper C. Epidemiology of fractures in England and Wales. Bone 2001;29:517–22.

    Article  PubMed  Google Scholar 

  3. van Helden S, van Geel AC, Geusens PP, Kessels A, Nieuwenhuijzen Kruseman AC, Brink PR. Bone and fall-related fracture risks in women and men with a recent clinical fracture. J Bone Joint Surg Am 2008;90:241–8.

    Article  PubMed  Google Scholar 

  4. Endres HG, Dasch B, Lungenhausen M, Maier C, Smektala R, Trampisch HJ, Pientka L. Patients with femoral or distal forearm fracture in Germany: a prospective observational study on health care situation and outcome. BMC Public Health 2006;6:87.

    Article  PubMed  Google Scholar 

  5. O’Neill TW, Cooper C, Finn JD, Lunt M, Purdie D, Reid DM, Rowe R, Woolf AD, Wallace WA. Incidence of distal forearm fracture in British men and women. Osteoporos Int 2001;12:555–8.

    Article  PubMed  Google Scholar 

  6. Schwenkglenks M, Lippuner K, Hauselmann HJ, Szucs TD. A model of osteoporosis impact in Switzerland 2000–2020. Osteoporos Int 2005;16:659–71.

    Article  PubMed  Google Scholar 

  7. Thompson PW, Taylor J, Dawson A. The annual incidence and seasonal variation of fractures of the distal radius in men and women over 25 years in Dorset, UK. Injury 2004;35:462–6.

    Article  PubMed  Google Scholar 

  8. Ismail AA, Pye SR, Cockerill WC, Lunt M, Silman AJ, Reeve J, Banzer D, Benevolenskaya LI, Bhalla A, Bruges Armas J, Cannata JB, Cooper C, Delmas PD, Dequeker J, Dilsen G, Falch JA, Felsch B, Felsenberg D, Finn JD, Gennari C, Hoszowski K, Jajic I, Janott J, Johnell O, Kanis JA, Kragl G, Lopez Vaz A, Lorenc R, Lyritis G, Marchand F, Masaryk P, Matthis C, Miazgowski T, Naves-Diaz M, Pols HA, Poor G, Rapado A, Raspe HH, Reid DM, Reisinger W, Scheidt-Nave C, Stepan J, Todd C, Weber K, Woolf AD, O’Neill TW. Incidence of limb fracture across Europe: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 2002;13:565–71.

    Article  PubMed  CAS  Google Scholar 

  9. Rud B, Greibe R, Hyldstrup L, Sorensen HA. Does a distal forearm fracture lead to evaluation for osteoporosis? A retrospective cohort study in 147 Danish women. J Clin Densitom 2005;8:18–24.

    Article  PubMed  Google Scholar 

  10. Fernandez DL. Should anatomic reduction be pursued in distal radial fractures? J Hand Surg (Br) 2000;25:523–7.

    CAS  Google Scholar 

  11. MacDermid JC, Donner A, Richards RS, Roth JH. Patient versus injury factors as predictors of pain and disability six months after a distal radius fracture. J Clin Epidemiol 2002;55:849–54.

    Article  PubMed  Google Scholar 

  12. Dias JJ, Wray CC, Jones JM. Osteoporosis and Colles’ fractures in the elderly. J Hand Surg (Br) 1987;12:57–9.

    CAS  Google Scholar 

  13. Itoh S, Ohta T, Samejima H, Shinomiya K. Bone mineral density in the distal radius in a healthy Japanese population and in relation to fractures of the distal radius. J Hand Surg (Br) 1999;24:334–7.

    CAS  Google Scholar 

  14. Kanis JA, Gluer CC, Committee of Scientific Advisors, International Osteoporosis Foundation. An update on the diagnosis and assessment of osteoporosis with densitometry. Osteoporos Int 2000;11:192–202.

    Article  PubMed  CAS  Google Scholar 

  15. Changulani M, Okonkwo U, Keswani T, Kalairajah Y. Outcome evaluation measures for wrist and hand - which one to choose? Int Orthop 2008;32:1–6.

    Article  PubMed  Google Scholar 

  16. Fernandez DL, Jupiter JB. Fracture of the distal radius. A practical approach to management. Springer, New York, 1995 26–50.

    Google Scholar 

  17. Chen JX, Gong J, Zhang TM, Wu QL, Xu H. Correlations between bone mineral density of the hand and other skeletal sites as measured by DXA in Chinese women and men. J Clin Densitom 2006;9:461–8.

    Article  PubMed  Google Scholar 

  18. Taaffe DR, Lewis B, Marcus R. Quantifying the effect of hand preference on upper limb bone mineral and soft tissue composition in young and elderly women by dual-energy X-ray absorptiometry. Clin Physiol 1994;14:393–404.

    Article  PubMed  CAS  Google Scholar 

  19. Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report WHO Study Group. Osteoporos Int 1994;4:368–81.

    Article  PubMed  CAS  Google Scholar 

  20. International Committee for Standards in Bone Measurement Standardization of proximal femur bone mineral density (BMD) measurements by DXA. Bone 1997;21:369–70.

    Article  Google Scholar 

  21. Gartland JJJr, Werley CW. Evaluation of healed Colles’ fractures. J Bone Joint Surg Am 1951;33-A:895–907.

    PubMed  Google Scholar 

  22. Hollevoet N, Van Maele G, Van Seymortier P, Verdonk R. Comparison of palmar tilt, radial inclination and ulnar variance in left and right wrists. J Hand Surg (Br) 2000;25:431–3.

    CAS  Google Scholar 

  23. Celiktas M, Kozanoglu E, Aikimbaev KS, Soyupak S, Binokay F. Osteopenia and osteoporosis in postmenopausal women. Assessment by radiogrammetric measurement. Acta Radiol 2002;43:609–14.

    Article  PubMed  CAS  Google Scholar 

  24. Hollevoet N, Goemaere S, Mortier F, Van Bouchaute P, Kaufman JM, Verdonk R. The role of osteoporosis in distal radius fractures. Acta Orthop Belg 2000;66:163–8.

    PubMed  CAS  Google Scholar 

  25. Hollevoet N, Verdonk R. Outcome of distal radius fractures in relation to bone mineral density. Acta Orthop Belg 2003;69:510–4.

    PubMed  Google Scholar 

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Correspondence to Tim A. E. J. Boymans.

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Boymans, T.A.E.J., van Helden, S., Kessels, A. et al. Bone Mineral Density is Not Correlated with One-Year Functional Outcome in Distal Radial Fractures: A Preliminary Study. Eur J Trauma Emerg Surg 35, 281–286 (2009). https://doi.org/10.1007/s00068-008-8120-y

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  • DOI: https://doi.org/10.1007/s00068-008-8120-y

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