EXPERIENCES WITH OSTEODENSITOMETRY AFTER DISTAL RADIUS FRACTURES CAUSED BY MINOR TRAUMA

Abstract

INTRODUCTION: To determine the bone mineral density (BMD), the osteoporosis risk factors and the wrist function after distal radius fractures, treated by non-operative methods at the Orthopaedic Department of Semmelweis University Budapest.

MATERIALS AND METHODS: 55 patients, between January 1999 and December 2000 (47 to 90, mean age: 69.4 years) were treated non-operatively after distal radius fracture following minor trauma. The osteoporosis risk factors were detected by an interview format and the BMD was measured in the proximal femur, in level LII.-LIV. vertebras and in the contralateral radius. An adapted interview format was filled in six months following fracture healing to detect the wrist function.

RESULTS: Of the wrist-fractured patients 78% are osteoporotic, 20% are osteopenic in one of the examined region. 72.5% are osteoporotic and 17.5% are osteopenic at the contralateral radius. The T score is below −1 in LII–LIV. and the hip region in 80.36% and 67.92% respectively. Some of the patients had earlier fractures. Those, who had previous fracture before the age of 70, are all osteoporotic, and those who had no fracture previously are 64.5% osteoporotic, 22.5% osteopenic at the contralateral radius. At the LII–LIV vertebras, those who had previous fracture, 60% are osteoporotic and 33.3% osteopenic and those who had no fracture previously are 27.7% osteoporotic, 44.4% osteopenic. At the proximal femur region, those who had previous fracture, 23% are osteoporotic and 53.8% osteopenic and those who had no fracture previously are 16.2% osteoporotic, 48.6% osteopenic. Patients with body mass index (BMI) under 25 are more osteoporotic in all of the measured region, than those with BMI over 25. We did not find significal difference in wrist function of those who had a redislocation of 5° to 20° after the reposition and those who had fracture healing in an anatomical reposition.

CONCLUSIONS: The examined patients with a distal radius fracture are a high risk population because of their high percentage of lower BMD. A wrist fracture resulted by minor trauma must be a warning sign: there is a higher probability of a following fracture due to osteoporosis. This might have a negative effect on life quality too. Therefore after a distal radius fracture there is a major importance of detecting the risk factors for osteoporosis, measuring the BMD in high-risk cases and starting the antiporotic therapy at the same time, to decrease the proximal femur and vertebral fractures rate.