Osteoporosis in Elderly Patients with Distal Radius Fractures

Distal radius is the most common site of fracture in older postmenopausal women, with a lifetime risk of 15%. Evidence exists for its association with osteoporosis. Osteoporosis can be detected by measuring the bone mineral density (BMD) of the lumbar spine with dual energy X-ray absorptiometry. Low BMD of the lumbar spine or hip is a strong predictor for future vertebral deformity and hip fracture. Elderly women with distal radial fracture are not investigated for osteoporosis on a routine basis. The aim of the present study is to evaluate the relationship between distal radius fracture and the BMD of the lumbar spine, and to investigate the need for osteoporosis screening in elderly women with a distal radius fracture. A prospective study was performed in a hospital in Mashhad in 2004-2005. In 104 women (mean age, 66.9 years) with a distal radius fracture, BMD of the lumbar spine was assessed. A biosphosphonate was prescribed when osteoporosis was diagnosed, and the BMD was reassessed after 2 years of treatment. A low BMD was found in 87 patients (83.65%). Osteoporosis was diagnosed in 46 (44.23%) and osteopenia in 41(39.42%) patients. Only 17 cases (16.23%) had normal bone density. The mean T-score of the lumbar spine was –2.10 (±1.06). The BMD in patients treated with bisphosphonate medication increased from T-score of -2.88 to -2.55 in 2 years (p<0/01). Since near half of the elderly women with a distal radius fracture have osteoporotic BMD values for the lumbar spine, it is advised to screen such a group of patients for osteoporosis.