Abstract

BackgroundBone mineral density (BMD) has been shown to be a consistent and independent risk factor for distal radius fracture. Inconsistent data have been reported on the association between BMD and severity of distal radius fracture. Our primary aim was to explore if there is an association between cortical BMD at the hand and the severity of fragility distal radius fracture.MethodsConsecutively recruited females aged ≥50 years with fragility fracture at the distal radius (n = 110) from a county hospital were included. Cortical hand BMD was assessed by the digital X-ray radiogrammetry (DXR) method. X-rays of the fracture were scored by experienced orthopedic surgeons for fracture severity according to the Müller AO classification of long bones and radiographic parameters such as ulnar variance and dorsal angle.ResultsA weak association between lower DXR BMD and increased ulnar variance and dorsal angle was found but not with the AO scoring system for fracture type. A history of glucocorticoid (GC) use but not DXR-BMD was found to be significantly associated with the presence of having an intra- or extra-articular fracture.ConclusionOur data indicate that bone material properties which are impaired by GC use are more important for fracture severity than BMD.

Highlights

  • Distal radius fracture is one of the most common osteoporotic fractures in the elderly [1]

  • We did not observe any significant association between decreased hand cortical digital X-ray radiogrammetry (DXR)-Bone mineral density (BMD) and the risk of having an intra-articular or extra-articular fragility fracture in distal radius scored according to the AO classification

  • A small significant negative correlation was found between lower hand DXR-BMD and initial fracture displacement measures as dorsal angle and ulnar variance; no significant association was found with carpal malalignment, articular step, or dorsal communition of the distal radius fracture

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Summary

Introduction

Distal radius fracture is one of the most common osteoporotic fractures in the elderly [1]. Reduced bone mineral density (BMD) has been identified as one of the most significant risk factors for distal radius fracture [2,3,4]. In a human cadaver study, reduced forearm BMD was found to correlate to the severity of the distal radius fracture [6]. The primary aim of the present study was to explore if there is an association between reduced cortical hand BMD measured with DXR and fracture severity. Bone mineral density (BMD) has been shown to be a consistent and independent risk factor for distal radius fracture. Inconsistent data have been reported on the association between BMD and severity of distal radius fracture. Our primary aim was to explore if there is an association between cortical BMD at the hand and the severity of fragility distal radius fracture. X-rays of the fracture were scored by experienced orthopedic surgeons for fracture severity according to the Müller AO classification of long bones and radiographic parameters such as ulnar variance and dorsal angle

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