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Distal radius fracture is an early sign of general osteoporosis: Bone mass measurements in a population-based study

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Abstract

To evaluate the bone mass by bone density measurements in patients with distal radius fracture, a prospective open case-control study was carried out in the county of Uppsala, Sweden, with population-based cases and controls. There were 111 patients with a distal radius fracture who were otherwise healthy and aged 53–76 years, together with 60 healthy controls of similar age, sex and menopausal status. The main outcome measures were bone mineral density (BMD) in the lumbar spine and hip measured with dual-energy X-ray absorptiometry, and in the (non-fractured) distal forearm determined by single-photon absorptiometry. It was found that at all measuring sites BMD was significantly lower in cases than in controls. The difference in the distal forearm was around 20% (p<0.001) and in the spine and hip 5%–8% (p<0.05–0.001). In the healthy subjects there were positive correlations (r=0.39–0.65;p<0.002) between the forearm BMD and that of both the spine and hip, whereas in the patients with distal radius fracture there was only a weak correlation between the forearm and spine BMD (r=0.28;p<0.05) and no association between the BMD of the forearm and hip (r<0.01). It is concluded that patients with distal radius fracture who are otherwise healthy have a preferential bone loss at the distal forearm but also a generally low bone mass. Patients with fracture of the distal radius fracture should be considered for prophylactic measures against osteoporosis.

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References

  1. Mosekilde L, Bentzen SM, Örtoft G, Jörgensen J. The predictive value of quantitative computed tomography for vertebral body compressive strength and ash density. Bone 1989;10:465–70.

    Google Scholar 

  2. Hansson TH, Roos BO, Nachemson A. The bone mineral content and ultimate strength of lumbar vertebrae. Spine 1980;5:46–55.

    Google Scholar 

  3. Eriksson SA, Isberg BO, Lindgren JU. Prediction of vertebral strength by dual photon absorptiometry and quantitative computed tomography. Calcif Tissue Int 1989;44:243–50.

    Google Scholar 

  4. Melton LJ III, Wahner HW, Riggs BL. Bone density measurement [editorial]. J Bone Miner Res 1987;3:1–11.

    Google Scholar 

  5. Melton LJ III, Khan SH, Wahner HW, Riggs BL. Lifetime fracture risk: an approach to hip fracture risk assessment based on bone mineral density and age. J Clin Epidemiol 1988;41:985–94.

    Google Scholar 

  6. Hui SL, Slemenda CW, Johnston CC. Age and bone mass as predictors of fracture in a prospective study. J Clin Invest 1988;81:1804–9.

    Google Scholar 

  7. Hui SL, Slemenda CW, Johnston CC. Baseline measurements of bone mass predicts fracture in white women. Ann Intern Med 1989;111:355–61.

    Google Scholar 

  8. Gardsell P, Johnell O, Nilsson BE. Predicting fractures in women by using forearm bone densitometry. Calcif Tissue Int 1989;44:235–42.

    Google Scholar 

  9. Johnston CC, Melton LJ, Lindsay R. Clinical indications for bone mass measurements. J Bone Miner Res 1989;4(Suppl 2):1–28.

    Google Scholar 

  10. Cummings SR, Black DM, Nevitt MC, et al. Appendicular bone density and age predict hip fracture in women. JAMA 1990;263:665–8.

    Google Scholar 

  11. Seely DG, Browner WS, Nevitt MC, Genant HK, Scott JC, Cummings SR. Which fractures are associated with low appendicular bone mass in elderly women? Ann Interm Med 1991;115:837–42.

    Google Scholar 

  12. Hall FM, Davis MA, Baran DT. Bone mineral screening for osteoporosis. N Engl J Med 1987;316:212–4.

    Google Scholar 

  13. Riggs LB, Wahner HW. Bone densitometry and clinical decision making in osteoporosis, [editorial]. Ann Intern Med 1988;108:293–5.

    Google Scholar 

  14. Genant HK, Block JE, Steiger P, Glueer CC, Ettinger B, Harris ST. Appropriate use of bone densitometry. Radiology 1989;170:817–22.

    Google Scholar 

  15. Raffle AE, Cooper C. Bone density screening for osteoporosis [letter]. Lancet 1990;1:242.

    Google Scholar 

  16. Melton LJ III, Eddy DM, Johnston CC. Screening for osteoporosis. Ann Intern Med 1990;112:516–28.

    Google Scholar 

  17. Tosteson ANA, Rosenthal DI, Melton LJ III. Cost effectiveness of screening perimenopausal white women for osteoporosis: bone densitometry and hormone replacement therapy. Ann Intern Med 1990;113:594–603.

    Google Scholar 

  18. Bengnér U, Johnell O. Increasing incidence of forearm fractures: a comparison of epidemiologic patterns 25 years apart. Acta Orthop Scand 1985;56:158–60.

    Google Scholar 

  19. Mallmin H, Ljunghall S. Incidence of Colles' fracture in Uppsala: a prospective study of a quarter million population. Acta Orthop Scand 1992;63:213–5.

    Google Scholar 

  20. Eastell R, Wahner HW, O'Fallon M, Amadio PC, Melton LJ III, Riggs BL. Unequal decrease in bone density of lumbar spine and ultradistal radius in Colles' and vertebral fracture syndromes. J Clin Invest 1989;83:168–74.

    Google Scholar 

  21. Nilsson BE, Westlin NE. The bone mineral content in the forearm of women with Colles' fracture. Acta Orthop Scand 1974;45:836–44.

    Google Scholar 

  22. Nordin BE, Wishart JM, Horowitz M, Need AG, Bridges A, Bellon M. The relation between forearm and vertebral mineral density and fractures in postmenopausal women. Bone Miner 1988;5:21–33.

    Google Scholar 

  23. Hesp R, Klenerman L, Page L. Decreased radial bone mass in Colles' fracture. Acta Orthop Scand 1984;55:573–5.

    Google Scholar 

  24. Härmä M, Karjalainen PP. Trabecular osteopenia in Colles' fracture. Acta Orthop Scand 1986;57:38–40.

    Google Scholar 

  25. Mallmin H, Ljunghall S, Naessen T. Colles' fracture associated with reduced bone mineral content: photon densitometry in 74 patients withmatched controls. Acta Orthop Scand 1992;63:552–4.

    Google Scholar 

  26. Ott SM, Kilcoyne RF, Chestnut CH III. Comparisons among methods of measuring bone mass and relationships to severity of vertebral fractures in osteoporosis. J Clin Endocrinol Metab 1988;66:501–7.

    Google Scholar 

  27. Chevalley T, Rizzoli R, Nydegger V, et al. Preferential low bone mineral density of the femoral neck in patients with a recent fracture of the proximal femur. Osteoporosis Int 1991;1:147–54.

    Google Scholar 

  28. Westlin NE. Loss of bone mineral after Colles' fracture. Clin Orthop 1974;102:194–9.

    Google Scholar 

  29. Heaney RP. Bone mass and osteoporotic fractures [editorial]. Calcif Tissue Int 1990;47:63–5.

    Google Scholar 

  30. Ross PD, Davis JW, Vogel JM, Wasnich RD. A critical review of bone mass and the risk of fractures in osteoporosis. Calcif Tissue Int 1990;46:149–61.

    Google Scholar 

  31. Crilly RG, Richardson JHLD, Roth JH, Vandervoort AA, Hayes KC, Mackenzie RA. Postural stability and Colles' fracture. Age Ageing 1987;16:133–8.

    Google Scholar 

  32. Winner SJ, Morgan CA, Grimley Evans J. Perimenopausal risk of falling and incidence of distal forearm fracture. BMJ 1989;298:1486–8.

    Google Scholar 

  33. Mallmin H, Ljunghall S, Larsson K, Lindh E. Short-term effects of pamidronate on biochemical markers of bone metabolism in osteoporosis: a placebo-controlled dose-finding study. Ups J Med Sci 1991;96:202–12.

    Google Scholar 

  34. Cummings SR, Kelsey JL, Nevitt MC, O'Dowd KJ. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev 1985;7:178–208.

    Google Scholar 

  35. Riggs BL, Melton LJ III. Involutional osteoporosis. N Engl J Med 1986;314:1676–86.

    Google Scholar 

  36. Johnell O, Sernbo I. Health and social status in patients with hip fractures and controls. Age Ageing 1986;15:285–91.

    Google Scholar 

  37. Bauer GCH. Epidemiology of fracture in aged persons: a preliminary investigation in fracture etiology. Clin Orthop 1960;19:219–25.

    Google Scholar 

  38. Obrant KJ, Bengnér U, Johnell O, Nilsson BE, Sernbo I. Increasing age-adjusted risk of fragility fractures: a sign of increasing osteoporosis in successive generations [editorial]. Calcif Tissue Int 1989;44:157–67.

    Google Scholar 

  39. Consensus Development Conference. Prophylaxis and treatment of osteoporosis. Am J Med 1991;90:107–10.

    Google Scholar 

  40. Mazess RB, Barden H, Ettinger M, Schulz E. Bone density on the radius, spine, and proximal femur in osteoporosis. J Bone Miner Res 1988;3:13–8.

    Google Scholar 

  41. Need AG, Nordin BEC. Which bone to measure? Osteporosis Int 1990;1:3–6.

    Google Scholar 

  42. Mazess RB, Peppier WW, Chesney RW, Lang TA, Lindgren U, Smith E. Does bone measurement on the radius indicate skeletal status? J Nucl Med 1984;25:281–8.

    Google Scholar 

  43. Stevenson JC, Lees B, Devenport M, Cust MP, Ganger KF. Determinants of bone density in normal women: risk factors for future osteoporosis. BMJ 1989;298:924–8.

    Google Scholar 

  44. Halioua L, Anderson JJB. Age and anthropometric determinants of radial bone mass in premenopausal Caucasian women: a cross-sectional study. Osteoporosis Int 1990;1:50–5.

    Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics, University Hospital, S-751 85, Uppsala, Sweden

    H. Mallmin

  2. Department of Internal Medicine, University Hospital, Uppsala, Sweden

    S. Ljunghall

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  1. H. Mallmin
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  2. S. Ljunghall
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Mallmin, H., Ljunghall, S. Distal radius fracture is an early sign of general osteoporosis: Bone mass measurements in a population-based study. Osteoporosis Int 4, 357–361 (1994). https://doi.org/10.1007/BF01622198

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  • DOI: https://doi.org/10.1007/BF01622198

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