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Inadequate management for secondary fracture prevention in patients with distal radius fracture by trauma surgeons

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Abstract

Summary

We evaluated the secondary fracture prevention in 1445 patients with distal radius fracture by trauma surgeons. The rate of patients with distal radius fracture who underwent bone mineral density (BMD) examination was low, suggesting that appropriate treatment for osteoporosis by trauma surgeons is not performed at present.

Introduction

To clarify the status of osteoporosis interventions after distal radial fractures by trauma surgeons who play the main role in treatment for these fractures, we performed a survey involving multiple institutions in Japan.

Methods

We asked 155 board members of the Japanese Society for Fracture Repair for their cooperation and performed a survey in 48 institutions with which members who gave cooperation were affiliated. The subjects consisted of consecutive patients with distal radial fractures occurring between January and December 2012. The presence or absence of a diagnosis of osteoporosis and bone mineral density examination after fracture was investigated.

Results

A total of 1445 patients with distal radial fractures were evaluated in this study. BMD examination for diagnosis and treatment for osteoporosis after fracture was performed respectively in 126 (8.7 %) and 193 (13.4 %) of 1445 patients. Treatment for osteoporosis was performed in 93 (73.8 %) of 126 patients who underwent BMD examination after fracture and 100 (8.2 %) of 1219 who did not undergo BMD examination. Of the 126 patients who underwent BMD examination after fracture, 89 showed a BMD <80 % of the young adult mean as a criterion for the initiation of drug treatment for osteoporosis in Japan and 77 (86.5 %) of the 89 patients were treated with drugs.

Conclusions

The rate of patients with distal radial fractures who underwent BMD examination was low, suggesting that appropriate treatment for osteoporosis by trauma surgeons is not performed at present.

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References

  1. Kuzuya M (2012) Process of physical disability among older adults—contribution of frailty in the super-aged society. Nagoya J Med Sci 74:31–37

    PubMed  Google Scholar 

  2. Aoyagi Y, Shephard RJ (2011) A model to estimate the potential for a physical activity-induced reduction in healthcare costs for the elderly, based on pedometer/accelerometer data from the Nakanojo Study. Sports Med 41:695–708

    Article  PubMed  Google Scholar 

  3. Yi H, Ha YC, Lee YK, Lim YT (2013) National healthcare budget impact analysis of the treatment for osteoporosis and fractures in Korea. J Bone Metab 20:17–23

    Article  PubMed Central  PubMed  Google Scholar 

  4. Branco JC, Felicíssimo P, Monteiro J (2009) Epidemiology of hip fractures and its social and economic impact. A revision of severe osteoporosis current standard of care. Acta Reumatol Port 34:475–485

    PubMed  Google Scholar 

  5. Svedbom A, Ivergård M, Hernlund E, Rizzoli R, Kanis JA (2014) Epidemiology and economic burden of osteoporosis in Switzerland. Arch Osteoporos 9:187

    Article  CAS  PubMed  Google Scholar 

  6. Lentle B, Cheung AM, Hanley DA, Leslie WD, Lyons D, Papaioannou A, Atkinson S, Brown JP, Feldman S, Hodsman AB, Jamal AS, Josse RG, Kaiser SM, Kvern B, Morin S, Siminoski K, Scientific Advisory Council of Osteoporosis Canada (2011) Osteoporosis Canada 2010 guidelines for the assessment of fracture risk. Can Assoc Radiol J 62:243–250

    Article  PubMed  Google Scholar 

  7. Andrade SE, Majumdar SR, Chan KA, Buist DS, Go AS, Goodman M, Smith DH, Platt R, Gurwitz JH (2003) Low frequency of treatment of osteoporosis among postmenopausal women following a fracture. Arch Intern Med 163:2052–2057

    Article  PubMed  Google Scholar 

  8. Majumdar SR, Rowe BH, Folk D, Johnson JA, Holroyd BH, Morrish DW, Maksymowych WP, Steiner IP, Harley CH, Wirzba BJ, Hanley DA, Blitz S, Russell AS (2004) A controlled trial to increase detection and treatment of osteoporosis in older patients with a wrist fracture. Am Coll Physicians 141:366–374

    Google Scholar 

  9. Mallmin H, Ljunghall S, Persson I, Naessén T, Krusemo UB, Bergström R (1993) Fracture of the distal forearm as a forecaster of subsequent hip fracture: a population-based cohort study with 24 years of follow-up. Calcif Tissue Int 52:269–272

    Article  CAS  PubMed  Google Scholar 

  10. Peel NF, Barrington NA, Smith TW, Eastell R (1994) Distal forearm fracture as risk factor for vertebral osteoporosis. BMJ 308:1543–1544

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Earnshaw SA, Cawte SA, Worley A, Hosking DJ (1998) Colles’ fracture of the wrist as an indicator of underlying osteoporosis in postmenopausal women: a prospective study of bone mineral density and bone turnover rate. Osteoporos Int 8:53–60

    Article  CAS  PubMed  Google Scholar 

  12. Cuddihy MT, Amadio PC, Gabriel SE, Pankratz VS, Kurland RL, Melton LJ 3rd (2004) A prospective clinical practice intervention to improve osteoporosis management following distal forearm fracture. Osteoporos Int 15:695–700

    PubMed  Google Scholar 

  13. Freedman KB, Kaplan FS, Bilker WB, Strom BL, Lowe RT (2000) Treatment of osteoporosis: are physicians missing an opportunity? J Bone Joint Sur Am 82:1063–1070

    Google Scholar 

  14. Feldstein A, Elmer PJ, Orwoll E, Herson M, Hillier T (2003) Bone mineral density measurement and treatment for osteoporosis in older individuals with fractures: a gap in evidence-based practice guideline implementation. Arch Intern Med 163:2165–2172

    Article  PubMed  Google Scholar 

  15. Iba K, Takada J, Hatakeyama N, Kaya M, Isogai S, Tsuda H, Obata H, Miyano S, Yamashita T (2006) Underutilization of antiosteoporotic drugs by orthopedic surgeons for prevention of a secondary osteoporotic fracture. J Orthop Sci 11:446–449

    Article  PubMed  Google Scholar 

  16. Talbot JC, Elener C, Praveen P, Shaw DL (2007) Secondary prevention of osteoporosis: calcium, vitamin D and bisphosphonate prescribing following distal radial fracture. Injury 38:1236–1240

    Article  CAS  PubMed  Google Scholar 

  17. Japanese Orthopaedic Association (2012) Clinical practice guideline on the diagnosis, treatment of distal radius fracture. Nankodo, Tokyo

  18. Soen S, Fukunaga M, Sugimoto T, Sone T, Fujiwara S, Endo N, Gorai I, Shiraki M, Hagino H, Hosoi T, Ohta H, Yoneda T, Tomomitsu T, Japanese Society for Bone and Mineral Research and Japan Osteoporosis Society Joint Review Committee for the Revision of the Diagnostic Criteria for Primary Osteoporosis (2013) Diagnostic criteria for primary osteoporosis: year 2012 revision. J Bone Miner Metab 31:247–257

    Article  PubMed  Google Scholar 

  19. Sakuma M, Endo N, Oinuma T, Endo E, Yazawa T, Watanabe K, Watanabe S (2008) Incidence and outcome of osteoporotic fractures in 2004 in Sado City, Niigata Prefecture, Japan. J Bone Miner Metab 26:373–378

    Article  PubMed  Google Scholar 

  20. Hagino H, Sawaguchi T, Endo N, Ito Y, Nakano T, Watanabe Y (2012) The risk of a second hip fracture in patients after their first hip fracture. Calcif Tissue Int 90:14–21

    Article  CAS  PubMed  Google Scholar 

  21. Krailo MD, Pike MC (1983) Estimation of the distribution of age at natural menopause from prevalence data. J Am J Epidemiol 117:356–1361

    CAS  Google Scholar 

  22. Luoto R, Kaprio J, Uutela A (1994) Age at natural menopause and sociodemographic status in Finland. Am J Epidemiol 139:64–76

    CAS  PubMed  Google Scholar 

  23. Rozental TD, Makhni EC, Day CS, Bouxsein ML (2008) Improving evaluation and treatment for osteoporosis following distal radial fractures. A prospective randomized intervention. J Bone Joint Surg Am 90:953–961

    Article  PubMed  Google Scholar 

  24. Sontag A, Krege JH (2010) First fractures among postmenopausal women with osteoporosis. J Bone Miner Metab 28:485–488

    Article  CAS  PubMed  Google Scholar 

  25. Cummings SR, Nevitt MC, Browner WS, Stone K, Fox KM, Ensrud KE, Cauley J, Black D, Vogt TM (1995) Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med 332:767–773

    Article  CAS  PubMed  Google Scholar 

  26. Lauritzen JB, Schwarz P, Lund B, McNair P, Transbøl I (1993) Radial and humeral fractures as predictors of subsequent hip, radial or humeral fractures in women, and their seasonal variation. Osteoporos Int 3:133–137

    Article  CAS  PubMed  Google Scholar 

  27. Robinson CM, Royds M, Abraham A, McQueen MM, Court-Brown CM, Christie J (2002) Refractures in patients at least forty-five years old. A prospective analysis of twenty-two thousand and sixty patients. J Bone Joint Surg Am 84:1528–1533

    Article  PubMed  Google Scholar 

  28. Orimo H, Hayashi Y, Fukunaga M, Sone T, Fujiwara S, Shiraki M, Kushida K, Miyamoto S, Soen S, Nishimura J, Oh-Hashi Y, Hosoi T, Gorai I, Tanaka H, Igai T, Kishimoto H, Osteoporosis Diagnostic Criteria Review Committee: Japanese Society for Bone and Mineral Research (2001) Diagnostic criteria for primary osteoporosis: year 2000 revision. J Bone Miner Metab 19:331–337

    Article  CAS  PubMed  Google Scholar 

  29. No authors listed (1991) Consensus development conference: prophylaxis and treatment of osteoporosis. Osteoporos Int 1: 114–117

  30. Drobetz H, Kutscha-Lissberg E (2003) Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop 27:1–6

    CAS  PubMed Central  PubMed  Google Scholar 

  31. Sommer C, Gautier E, Müller M, Helfet DL, Wagner M (2003) First clinical results of the locking compression plate (LCP). Injury 34(Suppl 2):B43–B54

    Article  PubMed  Google Scholar 

  32. Karantana A, Downing ND, Forward DP, Hatton M, Taylor AM, Scammell BE, Moran CG, Davis TR (2013) Surgical treatment of distal radial fractures with a volar locking plate versus conventional percutaneous methods: a randomized controlled trial. J Bone Joint Surg Am 95:1737–1744

    Article  PubMed  Google Scholar 

  33. Xie X, Xie X, Qin H, Shen L, Zhang C (2013) Comparison of internal and external fixation of distal radius fractures. Acta Orthop 84:286–291

    Article  PubMed Central  PubMed  Google Scholar 

  34. Huntjens KM, van Geel TA, van den Bergh JP, van Helden S, Willems P, Winkens B, Eisman JA, Geusens PP, Brink PR (2014) Fracture liaison service: impact on subsequent nonvertebral fracture incidence and mortality. J Bone Joint Surg Am 96(4):e29. doi:10.2106/JBJS.L.00223

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors sincerely acknowledge the 155 board members of the Japanese Society for Fracture Repair for their cooperation.

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Correspondence to T. Baba.

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Baba, T., Hagino, H., Nonomiya, H. et al. Inadequate management for secondary fracture prevention in patients with distal radius fracture by trauma surgeons. Osteoporos Int 26, 1959–1963 (2015). https://doi.org/10.1007/s00198-015-3103-4

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  • DOI: https://doi.org/10.1007/s00198-015-3103-4

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