Abstract
Summary
There is a lack of data on the prevalence of osteoporosis in patients with distal radius fractures occurring at the various seasons. The prevalence of osteoporosis is high, both in patients with indoor and outdoor fractures and higher than in controls. All female distal radius fracture patients ≥50 years should be referred for osteoporosis assessment.
Introduction
The objectives of this study in female distal radius fracture patients were to investigate seasonal differences, estimate the prevalence of osteoporosis, and identify factors associated with distal radius fractures compared with controls.
Methods
In a 2-year period, 263 women ≥50 years suffered a low-energy distal radius fracture in the geographic catchment area. The 214 women who met for osteoporosis assessment were age-matched with 191 controls. Bone mineral density was assessed by dual energy X-ray absorptiometry at femoral neck, total hip, and lumbar spine. Demographic and clinical data were collected.
Results
The prevalence of indoor fractures showed no seasonal variance. For outdoor fractures, the prevalence was highest in the winter months. The prevalence of osteoporosis among patients with indoor fractures was higher (58.5%) than outdoor fractures without (38.6%) and with snow/ice (36.0%; p < 0.001). The prevalence of osteoporosis was higher in fracture patients (42.5%) than controls (24.1%; p < 0.001), this was also found in the youngest age group 50–59 years (22.2% vs 1.8%; p < 0.001). In conditional logistic regression analyses osteoporosis, current use of glucocorticoids, and living alone were independently associated with distal radius fractures.
Conclusions
Our study highlights that environmental factor, as well as osteoporosis are associated with distal radius fractures in middle-aged and elderly women. Osteoporosis is also frequently found in outdoor patients, thus, all female distal radius fracture patients ≥50 years should be referred for osteoporosis assessment.
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References
McLellan AR, Gallacher SJ, Fraser M, McQuillian C (2003) The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int 14:1028–1034
Kanterewicz E, Yanez A, Perez-Pons A, Codony I, Del Rio L, Diez-Perez A (2002) Association between Colles’ fracture and low bone mass: age-based differences in postmenopausal women. Osteoporos Int 13:824–828
Löfman O, Hallberg I, Berglund K, Wahlstrom O, Kartous L, Rosenqvist AM, Larsson L, Toss G (2007) Women with low-energy fracture should be investigated for osteoporosis. Acta Orthop 78:813–821
Thompson PW, Taylor J, Dawson A (2004) The annual incidence and seasonal variation of fractures of the distal radius in men and women over 25 years in Dorset, UK. Injury 35:462–466
Falch JA (1983) Epidemiology of fractures of the distal forearm in Oslo, Norway. Acta Orthop Scand 54:291–295
Solgaard S, Petersen VS (1985) Epidemiology of distal radius fractures. Acta Orthop Scand 56:391–393
Bischoff-Ferrari HA, Orav JE, Barrett JA, Baron JA (2007) Effect of seasonality and weather on fracture risk in individuals 65 years and older. Osteoporos Int 18:1225–1233
Hemenway D, Colditz GA (1990) The effect of climate on fractures and deaths due to falls among white women. Accid Anal Prev 22:59–65
Jacobsen SJ, Sargent DJ, Atkinson EJ, O'Fallon WM, Melton LJ 3rd (1999) Contribution of weather to the seasonality of distal forearm fractures: a population-based study in Rochester, Minnesota. Osteoporos Int 9:254–259
Hove LM, Fjeldsgaard K, Reitan R, Skjeie R, Sörensen FK (1995) Fractures of the distal radius in a Norwegian city. Scand J Plast Reconstr Surg Hand Surg 29:263–267
Lauritzen JB, Schwarz P, McNair P, Lund B, Transbol 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
Cauley JA, Seeley DG, Ensrud K, Ettinger B, Black D, Cummings SR (1995) Estrogen replacement therapy and fractures in older women. Study of Osteoporotic Fractures Research Group. Ann Intern Med 122:9–16
Hagino H, Fujiwara S, Nakashima E, Nanjo Y, Teshima R (2004) Case-control study of risk factors for fractures of the distal radius and proximal humerus among the Japanese population. Osteoporos Int 15:226–230
Holmberg AH, Johnell O, Nilsson PM, Nilsson J, Berglund G, Akesson K (2006) Risk factors for fragility fracture in middle age. A prospective population-based study of 33, 000 men and women. Osteoporos Int 17:1065–1077
Honkanen RJ, Honkanen K, Kroger H, Alhava E, Tuppurainen M, Saarikoski S (2000) Risk factors for perimenopausal distal forearm fracture. Osteoporos Int 11:265–270
Ivers RQ, Cumming RG, Mitchell P, Peduto AJ (2002) Risk factors for fractures of the wrist, shoulder, and ankle: the Blue Mountains Eye Study. Osteoporos Int 13:513–518
Kelsey JL, Browner WS, Seeley DG, Nevitt MC, Cummings SR (1992) Risk factors for fractures of the distal forearm and proximal humerus. The Study of Osteoporotic Fractures Research Group. Am J Epidemiol 135:477–489
Kelsey JL, Prill MM, Keegan TH, Tanner HE, Bernstein AL, Quesenberry CP Jr, Sidney S (2005) Reducing the risk for distal forearm fracture: preserve bone mass, slow down, and don’t fall! Osteoporos Int 16:681–690
Mallmin H, Ljunghall S, Persson I, Bergstrom R (1994) Risk factors for fractures of the distal forearm: a population-based case-control study. Osteoporos Int 4:298–304
Silman AJ (2003) Risk factors for Colles’ fracture in men and women: results from the European Prospective Osteoporosis Study. Osteoporos Int 14:213–218
Vogt MT, Cauley JA, Tomaino MM, Stone K, Williams JR, Herndon JH (2002) Distal radius fractures in older women: a 10-year follow-up study of descriptive characteristics and risk factors. The study of osteoporotic fractures. J Am Geriatr Soc 50:97–103
Winner SJ, Morgan CA, Evans JG (1989) Perimenopausal risk of falling and incidence of distal forearm fracture. BMJ 298:1486–1488
Van Staa TP, Leufkens HG, Abenhaim L, Zhang B, Cooper C (2000) Use of oral corticosteroids and risk of fractures. J Bone Miner Res 15:993–1000
McLellan AFM (2001) Fractures in women over 50 years: implications for the secondary prevention of osteoporotic fractures. J Bone Miner Res 16:290
Cooper C, Melton LJ 3rd (1996) Magnitude and impact of osteoporosis and fractures. Academic Press, San Diego
Rockwood CA, Green DP, Bucholz RW (2006) Rockwood and Green's fractures in adults. Lippincott William and Wilkins, Philadelphia
Mazess RB, Barden H (1999) Bone density of the spine and femur in adult white females. Calcif Tissue Int 65:91–99
Altman D (1999) Comparing groups: categorical data. Practical statistics for medical research. Chapman and Hall/CRC, London
Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767
Korpelainen R, Korpelainen J, Heikkinen J, Vaananen K, Keinanen-Kiukaanniemi S (2006) Lifelong risk factors for osteoporosis and fractures in elderly women with low body mass index—a population-based study. Bone 39:385–391
Faulkner KA, Cauley JA, Zmuda JM, Griffin JM, Nevitt MC (2003) Is social integration associated with the risk of falling in older community-dwelling women? J Gerontol 58:954–959
Walsh LJ, Wong CA, Pringle M, Tattersfield AE (1996) Use of oral corticosteroids in the community and the prevention of secondary osteoporosis: a cross sectional study. BMJ 313:344–346
Devogelaer JP, Goemaere S, Boonen S, Body JJ, Kaufman JM, Reginster JY, Rozenberg S, Boutsen Y (2006) Evidence-based guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis: a consensus document of the Belgian Bone Club. Osteoporos Int 17:8–19
van Staa TP, Leufkens HG, Abenhaim L, Zhang B, Cooper C (2000) Oral corticosteroids and fracture risk: relationship to daily and cumulative doses. Rheumatology 39:1383–1389
Steinbuch M, Youket TE, Cohen S (2004) Oral glucocorticoid use is associated with an increased risk of fracture. Osteoporos Int 15:323–328
Acknowledgements
We gratefully appreciate the expert technical assistance and help with the data collection of the osteoporosis nurses Lillann Krüger Hæstad, Hanne Vestaby, Tove Kjøstvedt, and Åse Birkedal. This work has been supported and funded by the Competence Development Fund of Southern Norway and Sørlandet Hospital HF, Norway.
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Øyen, J., Rohde, G.E., Hochberg, M. et al. Low-energy distal radius fractures in middle-aged and elderly women—seasonal variations, prevalence of osteoporosis, and associates with fractures. Osteoporos Int 21, 1247–1255 (2010). https://doi.org/10.1007/s00198-009-1065-0
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DOI: https://doi.org/10.1007/s00198-009-1065-0