Diagnosis and treatment incidence of osteoporosis in patients with distal radius fractures
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Published:
May 2, 2019
Keywords:
0steoporosis, bone mineraldensity, distal radius fractures
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Abstract
Introduction: Distal radius fractures in elderly patients are an indicator of osteoporosis. The aim of this study was to determine osteoporosis diagnosis and treatment in patients with distal radius fractures treated surgically at our institution between 2012 and 2014.Methods:Information of 41 patients who had surgical intervention for distal radius fracture was obtained through telephones interviews. Several variables evaluated: age, sex, smoking, associated pathologies, previous fractures, preoperative and postoperative anti-osteoporotic treatments, specialty of the physicians that indicated antiosteoporotic treatment, and bone mineral density (BMD) studies performed.Results: The study included 41 patients (32 female).Twenty-six had a BMD performed before the fracture (15 evidenced osteoporosis), 11 had had previous fractures secondary to osteoporosis. Only 7patients were under anti-osteoporotic treatment to the moment of the fracture. After surgery, only 4 of the patients continued with the treatment. Pathological BMD had certain degree of associationwith the presence of Diabetes (type 2), but not with other comorbidities. The annual incidence rate of osteoporosis, calculated using all patients attended at our institution in 2014, was about 1%. Orthopedic surgeons indicated only 1.5% of the total number of BMDs prescribed that year.Conclusion: Our study suggests that there is poor prevention by orthopedic surgeons of secondary osteoporotic fractures, which is why a national prevention protocol for fractures secondary to osteoporosis would be considered necessary.
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Murillo, B., Allende Nores, C. A., & Rodríguez, O. (2019). Diagnosis and treatment incidence of osteoporosis in patients with distal radius fractures. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 84(2), 99-104. https://doi.org/10.15417/issn.1852-7434.2019.84.2.664
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Clinical Research
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https://doi.org/10.1016/j.injury.2007.03.004
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https://doi.org/10.1007/s11657-014-0182-3
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16. Baba T, Hagino H, Nonomiya H, Ikuta T, Shoda E, Mogami A, et al. Inadequate management for secondary fracture prevention in patients with distal radius fracture by trauma surgeons. Osteoporos Int 2015;26(7):1959-63. https://doi.org/10.1007/s00198-015-3103-4
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https://doi.org/10.1186/1754-9493-5-23
2. Schurman L, Galich AM, González C, González D, Messina OD, Sedlinsky C, et al. Guías Argentinas para el Diagnóstico, la Prevención y el Tratamiento de la Osteoporosis 2015. Actual Osteol 2017;13(2):136-156.
3. Earnshaw SA, Cawte SA, Worley A, Hosking DJ. 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 1998; 8:53-60. https://doi.org/10.1007/s001980050048
4. Owen RA, Melton LJ 3rd, Ilstrup DM, Johnson KA, Riggs BL. Colles fracture and risk of posterior hip fracture. Clin Orthop 1982;(171):37-43. https://doi.org/10.1097/00003086-198211000-00005
5. Harper C, Fitzpatrick S, Zurakowski D, Rosental TD. Distal radial fractures in older men, a missed opportunity? J Bone Joint Surg Am 2014; 96 (21):1820 -7. https://doi.org/10.2106/JBJS.M.01497
6. Oyen J, Brudvik C, Gjesdal C. Osteoporosis as a risk factor for distal radius fractures. J Bone Joint Surg Am 2016;93(4): 348-6. https://doi.org/10.2106/JBJS.J.00303
7. Rozental TD, Makhni CE, Day CS, Bouxsein ML. Improving evaluation and treatment for osteoporosis following distal radial fractures. A prospective randomized intervention. J Bone Joint Surg Am 2008;90(5): 953 -61. https://doi.org/10.2106/JBJS.G.01121
8. National Osteoporosis Foundation. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Washington, DC: National Osteoporosis Foundation; 2010:1-2.
9. Melton LJ 3rd, Chrischilles EA, Cooper C, Lane AW, Riggs BL. Perspective. How many women have osteoporosis? J Bone Miner Res 1992;7:1005-10.
https://www.ncbi.nlm.nih.gov/pubmed/1414493
10. Riggs BL, Melton LJ. Prevention and treatment of osteoporosis. N Engl J Med 1992;327:620-7.https://doi.org/10.1056/NEJM199208273270908
11. Park SB, Kim J, Jeong JH, Lee JK, Chin DK, Chung CK, et al. Prevalence and incidence of osteoporosis and osteoporotic vertebral fracture in Korea: Nationwide epidemiological study focusing on differences in socioeconomic status. Spine (Phila PA) 2016;41(4):328-36. https://doi.org/10.1097/BRS.0000000000001291
12. Talbot JC, Elener C, Praveen P, Shaw D. Secondary prevention of osteoporosis: calcium, vitamin D and bisphophonate prescribing following distal radial fracture. Injury 2007; 38:1236-40.
https://doi.org/10.1016/j.injury.2007.03.004
13. Wade SW, Strader C, Fitzpatrick LA, Anthony MS, O'Malley CD. Estimating prevalence of osteoporosis: examples from industrialized countries. Arch Osteoporos 2014;9:182.
https://doi.org/10.1007/s11657-014-0182-3
14. Svedbom M, Ivergard E, Hernlund R, Rizzoli R, Kanis JA. Epidemiology and economic burden of osteoporosis in Switzerland. Arch Osteoporos 2014 9:187. https://doi.org/10.1007/s11657-014-0187-y
15. Benzvi L, Gershon A, Lavi I, Wollstein R. Secondary prevention of osteoporosis following fragility fractures of the distal radius in a large health maintenance organization. Arch Osteoporos 2016;11:20. doi: https://doi.org/10.1007/s11657-016-0275-2
16. Baba T, Hagino H, Nonomiya H, Ikuta T, Shoda E, Mogami A, et al. Inadequate management for secondary fracture prevention in patients with distal radius fracture by trauma surgeons. Osteoporos Int 2015;26(7):1959-63. https://doi.org/10.1007/s00198-015-3103-4
17. Salica D, Buceta A, Palacios S, et al. Consenso Iberoamericano de Osteoporosis SIBOMM 2009. Osteoporosis: Prevención, Diagnóstico y Tratamiento. http://www.spodom.org/download/Consenso_SIBOMM2009.pdf
18. Rabenda V, Vanoverloop J, Fabri V, Mertens R, Sumkay F, Vannecke C, et al. Low incidence of anti-osteoporosis treatment after hip fracture. J Bone Joint Surg Am 2008;90:2142-8. https://doi.org/10.2106/JBJS.G.00864