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Osteoporosis International

Erschienen in:

16.04.2020 | Original Article

Osteoporosis care after distal radius fracture reduces subsequent hip or spine fractures: a 4-year longitudinal study

Erschienen in: Osteoporosis International | Ausgabe 8/2020

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Abstract

Summary

We evaluated whether active osteoporosis care in patients experiencing their first distal radius fracture (DRF) reduces subsequent hip or spine fractures by comparing two cohorts. The incidence of subsequent fractures was significantly lower in the active care cohort than the other cohort in 4-year follow-up.

Purpose

Studies show that osteoporosis care in patients with osteoporotic fracture reduces subsequent fractures, but the impact of such active care in patients with distal radius fracture (DRF) has not been well studied. We evaluated how much osteoporosis care in patients experiencing their first DRF can reduce subsequent hip or spine fractures at 4-year follow-up.

Methods

Active osteoporosis care by orthopedic surgeons for patients with DRF started from September 2009 at our institution, thus we had a unique opportunity to compare the two cohorts: pre-involvement (PreI) group (DRF before September 2009) and post-involvement (PostI) group (DRF from September 2009). We compared the two cohorts for subsequent hip or spine fracture incidence in the 4 years following DRF.

Results

Overall, 1057 patients with a DRF (85% women; mean age, 70 years) were studied, of whom 205 patients were in PreI group and 852 in PostI group. Subsequent fractures occurred in 27 patients (2.6%), with a mean interval of 29 months after DRF. The incidence was significantly lower in the PostI group than in the PreI group (1.9% vs. 5.4%, p = 0.004), especially in hip fractures (0.4% vs. 2.9%, p = 0.002). The relative risk reduction was 65% for all subsequent fractures and 86% for hip fractures.

Conclusion

This study demonstrates that active osteoporosis care in patients with DRF significantly reduces subsequent fracture incidence even for the 4-year follow-up period. These findings add an evidence for the current proactive osteoporosis care programs such as fracture liaison services.

Level of evidence

Therapeutic level III.

Black DM, Cooper C (2000) Epidemiology of fractures and assessment of fracture risk. Clin Lab Med 20:439–453CrossRef

Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res 22:465–475. https://doi.org/10.1359/jbmr.061113 CrossRefPubMed

Chen CW, Huang TL, Su LT, Kuo YC, Wu SC, Li CY, Chen KB, Sung FC (2013) Incidence of subsequent hip fractures is significantly increased within the first month after distal radius fracture in patients older than 60 years. J Trauma Acute Care Surg 74:317–321CrossRef

Crandall CJ, Hovey KM, Cauley JA, Andrews CA, Curtis JR, Wactawski-Wende J, Wright NC, Li W, LeBoff MS (2015) Wrist fracture and risk of subsequent fracture: findings from the women's health initiative study. J Bone Miner Res 30:2086–2095. https://doi.org/10.1002/jbmr.2559 CrossRefPubMedPubMedCentral

Barrett-Connor E, Sajjan SG, Siris ES, Miller PD, Chen YT, Markson LE (2008) Wrist fracture as a predictor of future fractures in younger versus older postmenopausal women: results from the National Osteoporosis Risk Assessment (NORA). Osteoporos Int 19:607–613. https://doi.org/10.1007/s00198-007-0508-8 CrossRefPubMed

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 3:133–137CrossRef

Gay JD (1974) Radial fracture as an indicator of osteoporosis: a 10-year follow-up study. Can Med Assoc J 111:156–157PubMedPubMedCentral

Khosla S, Cauley JA, Compston J, Kiel DP, Rosen C, Saag KG, Shane E (2017) Addressing the crisis in the treatment of osteoporosis: a path forward. J Bone Miner Res 32:424–430. https://doi.org/10.1002/jbmr.3074 CrossRefPubMed

Gong HS, Oh WS, Chung MS, Oh JH, Lee YH, Baek GH (2009) Patients with wrist fractures are less likely to be evaluated and managed for osteoporosis. J Bone Joint Surg Am 91:2376–2380. https://doi.org/10.2106/JBJS.H.01871 CrossRefPubMed

10.

Andrade SE, Majumdar SR, Chan KA, Buist DS, Go AS, Goodman M, Smith DH, Platt R, Gurwitz JH (2003) Low frequency of treatment of osteoporosis among postmenopausal women following a fracture. Arch Intern Med 163:2052–2057. https://doi.org/10.1001/archinte.163.17.2052 CrossRefPubMed

11.

Pflimlin A, Gournay A, Delabriere I, Chantelot C, Puisieux F, Cortet B, Paccou J (2019) Secondary prevention of osteoporotic fractures: evaluation of the Lille University Hospital’s fracture liaison service between January 2016 and January 2018. Osteoporos Int 30:1779–1788. https://doi.org/10.1007/s00198-019-05036-0 CrossRefPubMed

12.

Nakayama A, Major G, Holliday E, Attia J, Bogduk N (2016) Evidence of effectiveness of a fracture liaison service to reduce the re-fracture rate. Osteoporos Int 27:873–879. https://doi.org/10.1007/s00198-015-3443-0 CrossRefPubMed

13.

Sietsema DL, Araujo AB, Wang L, Boytsov NN, Pandya SA, Haynes VS, Faries DE, Taylor KA, Baser O, Jones CB (2018) The effectiveness of a private orthopaedic practice-based osteoporosis management service to reduce the risk of subsequent fractures. J Bone Joint Surg Am 100:1819–1828. https://doi.org/10.2106/JBJS.17.01388 CrossRefPubMed

14.

American Orthopaedic Association Own the Bone About own the bone. https://www.ownthebone.org/OTB/About/OTB/About/About.aspx?hkey=ab7a03e5-56fb-44f3-bb82-50b6cb533908 Accessed Sep 26 2019

15.

Tosi LL, Gliklich R, Kannan K, Koval KJ (2008) The American Orthopaedic Association’s “own the bone” initiative to prevent secondary fractures. J Bone Joint Surg Am 90:163–173. https://doi.org/10.2106/JBJS.G.00682 CrossRefPubMed

16.

Freedman KB, Kaplan FS, Bilker WB, Strom BL, Lowe RA (2000) Treatment of osteoporosis: are physicians missing an opportunity? J Bone Joint Surg Am 82:1063–1070. https://doi.org/10.2106/00004623-200008000-00001 CrossRefPubMed

17.

Newman ED, Ayoub WT, Starkey RH, Diehl JM, Wood GC (2003) Osteoporosis disease management in a rural health care population: hip fracture reduction and reduced costs in postmenopausal women after 5 years. Osteoporos Int 14:146–151. https://doi.org/10.1007/s00198-002-1336-5 CrossRefPubMed

18.

Axelsson KF, Jacobsson R, Lund D, Lorentzon M (2016) Effectiveness of a minimal resource fracture liaison service. Osteoporos Int 27:3165–3175. https://doi.org/10.1007/s00198-016-3643-2 CrossRefPubMedPubMedCentral

19.

Khan SA, de Geus C, Holroyd B, Russell AS (2001) Osteoporosis follow-up after wrist fractures following minor trauma. Arch Intern Med 161:1309–1312. https://doi.org/10.1001/archinte.161.10.1309 CrossRefPubMed

20.

Cuddihy MT, Gabriel SE, Crowson CS, Atkinson EJ, Tabini C, O'Fallon WM, Melton LJ 3rd (2002) Osteoporosis intervention following distal forearm fractures: a missed opportunity? Arch Intern Med 162:421–426. https://doi.org/10.1001/archinte.162.4.421 CrossRefPubMed

21.

Shah GM, Gong HS, Chae YJ, Kim YS, Kim J, Baek GH (2020) Evaluation and management of osteoporosis and sarcopenia in patients with distal radius fractures. Clin Orthop Surg 12:9–21. https://doi.org/10.4055/cios.2020.12.1.9 CrossRefPubMedPubMedCentral

22.

Dell RM, Greene D, Anderson D, Williams K (2009) Osteoporosis disease management: what every orthopaedic surgeon should know. J Bone Joint Surg Am 91(Suppl 6):79–86. https://doi.org/10.2106/JBJS.I.00521 CrossRefPubMed

23.

Shin YH, Gong HS, Gang DH, Shin HS, Kim J, Baek GH (2016) Evaluation of trabecular bone score in patients with a distal radius fracture. Osteoporos Int 27:3559–3565. https://doi.org/10.1007/s00198-016-3686-4 CrossRefPubMed

24.

Webber T, Patel SP, Pensak M, Fajolu O, Rozental TD, Wolf JM (2015) Correlation between distal radial cortical thickness and bone mineral density. J Hand Surg [Am] 40:493–499. https://doi.org/10.1016/j.jhsa.2014.12.015 CrossRef

25.

Michael Lewiecki E (2017) Osteoporosis: treat-to-target. Curr Osteoporos Rep 15:103–109. https://doi.org/10.1007/s11914-017-0350-7 CrossRefPubMed

26.

Adler RA, El-Hajj Fuleihan G, Bauer DC et al (2016) Managing osteoporosis in patients on long-term bisphosphonate treatment: report of a Task Force of the American Society for Bone and Mineral Research. J Bone Miner Res 31:16–35. https://doi.org/10.1002/jbmr.2708 CrossRefPubMedPubMedCentral

27.

Bouxsein ML, Eastell R, Lui LY, Wu LA, de Papp AE, Grauer A, Marin F, Cauley JA, Bauer DC, Black DM, FNIH Bone Quality Project (2019) Change in bone density and reduction in fracture risk: a meta-regression of published trials. J Bone Miner Res 34:632–642. https://doi.org/10.1002/jbmr.3641 CrossRef

Titel: Osteoporosis care after distal radius fracture reduces subsequent hip or spine fractures: a 4-year longitudinal study
Publikationsdatum: 16.04.2020
Erschienen in: Osteoporosis International / Ausgabe 8/2020
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-020-05410-3

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Osteoporosis care after distal radius fracture reduces subsequent hip or spine fractures: a 4-year longitudinal study

Abstract

Summary

Purpose

Methods

Results

Conclusion

Level of evidence

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Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Springer Medizin

Abstract

Summary

Purpose

Methods

Results

Conclusion

Level of evidence

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