A study of bone mineral density in women with forearm fracture in Northern Ireland

Abstract

A group of Northern Ireland women aged 40-75 years of age with low-trauma forearm fracture were studied to determine the incidence of such fractures and the prevalence of osteoporosis in this fracture population. A total of 1,147 subjects were identified in 1997 and 1998 throughout Northern Ireland following low-trauma forearm fractures, as well as 699 residents in the Eastern Health and Social Services Board (EHSSB), enabling calculation of the annual incidence rate of new low-trauma forearm fractures at 2.69/1,000 population aged 40-75. A total of 375 participants consented to have bone mineral density (BMD) measurements undertaken at the femoral neck, spine, and forearm using a Lunar Expert bone densitometer. Osteoporosis at the femur was present in 14% of women, at the spine in 29%, and at the forearm in 32%. A total of 45% were osteoporotic at one or more measured sites, but only 18% were on treatment for osteoporosis. Additional significant risk factors identified included an early menopause in 24.5% and current or previous corticosteroid use in 13%. Only 1.6% received information on treatment of osteoporosis at the time of fracture. Increased awareness is needed in both primary and secondary care including fracture services to improve treatment of women with low-trauma fracture.

DXA scanning in women over 50 years with distal forearm fracture shows osteoporosis is infrequent until age 65 years

“…Indeed the proportion of more than one third of patients aged 50–64 years receiving HRT is high given that this study was undertaken 3 years after the first Women's Health Initiative report (16). The proportion of patients with osteoporosis, defined by FN BMD, in this study matches a report from Northern Ireland using Lunar DXA (5). Nevertheless populations differ: in Scotland there was a significant difference in the proportion of the population with osteoporotic T ‐scores between two centres in the same city (4).…”

“…A study from Scotland allocated half the women with wrist fracture to a treatment group (4). In other surveys, osteoporosis at the femoral neck (FN) ( T < −2.5) existed only in 14–19% (2,5) of all women with wrist fractures. The proportion in younger women was even lower with only 7% of women with wrist fracture under 60 years having osteoporosis at the FN, the proportion classified as osteoporotic increasing to 20% if the lumbar spine BMD were included (5).…”

Assessing forearm fractures from eight prehistoric California populations

“…Risk factors identified in the study indicated that early onset menopause, previous hysterectomy, and smoking increased the amount of bone loss found in the females examined. Though this study focuses on aspects of osteoporosis, the indications of forearm trauma associated with these individuals suggests that we should see a greater number of fractures to the distal radius than either the hip or spine in older females (Beringer et al, 2005).…”

“…Another aspect of clinical research on forearm fractures focuses on the links between high incidences of distal radial fractures due to age related factors, i.e., osteoporosis and falls. Beringer et al, (2005) study examined 1147 females between the ages of 40-75 with low-trauma forearm fractures in an attempt to propose treatment options to reduce the onset of osteoporosis and secondary fracture prevention. Of the 1147 females, 365 participated in bone mineral density testing.…”

“…3. Does age and sex play a role in frequency and type of forearm fractures (Beringer et al, 2005;Butchart and Brown, 1991;DeSouza, 1968;Judd and Roberts, 1999;Lofthus et al, 2008;Lovejoy and Heiple, 1981;Mays, 1996;Mock et al, 1995, Nordvall et al, 2007Sharma, 2008)?…”