Exploring the relationship between bone density and severity of distal radius fragility fracture in women

Abstract

BackgroundBone mineral density (BMD) has been shown to be a consistent and independent risk factor for distal radius fracture. Inconsistent data have been reported on the association between BMD and severity of distal radius fracture. Our primary aim was to explore if there is an association between cortical BMD at the hand and the severity of fragility distal radius fracture.MethodsConsecutively recruited females aged ≥50 years with fragility fracture at the distal radius (n = 110) from a county hospital were included. Cortical hand BMD was assessed by the digital X-ray radiogrammetry (DXR) method. X-rays of the fracture were scored by experienced orthopedic surgeons for fracture severity according to the Müller AO classification of long bones and radiographic parameters such as ulnar variance and dorsal angle.ResultsA weak association between lower DXR BMD and increased ulnar variance and dorsal angle was found but not with the AO scoring system for fracture type. A history of glucocorticoid (GC) use but not DXR-BMD was found to be significantly associated with the presence of having an intra- or extra-articular fracture.ConclusionOur data indicate that bone material properties which are impaired by GC use are more important for fracture severity than BMD.

Evaluation of trabecular bone score in patients with a distal radius fracture

“…Furthermore, metacarpal cortical bone density, which is assessed by digital X-ray radiogrammetry, is significantly associated with a DRF in elderly women [28,29]. The occurrence of DRF is significantly related to hip BMD but not lumbar spine BMD [5,27], and severity of a DRF and cortical thickness of the distal radius are not related to BMD of the lumbar spine, which is mainly trabecular [27,30]. Second, even if trabecular microstructure affects frailty of the distal radius, it may not be accurately evaluated by the lumbar spine TBS due to anatomic site differences.…”

Cast-treated distal radius fractures: a prospective cohort study of radiological outcomes and their association with impaired calcaneal bone mineral density

“…Xie et al [33] found that cortical bone density measured with peripheral quantitative computer tomography was lower in patients with displaced than those with non-displaced distal radius fractures but no difference was found in femoral neck and lumbar spine DXA-measured BMD. Dhainaut et al [34] found a week correlation between cortical BMD measured with digital X-ray radiogrammetry and severity of distal radius fracture in terms of ulnar variance and volar tilt, but no association between fracture severity and DXA-measured hip and spine BMD was found. To our knowledge, studies of cortical bone density and risk of fracture malunion are still lacking.…”

“…Although the association between low BMD and risk of sustaining distal radius fracture is well known, studies of the possible association between BMD and severity of distal radius fracture have reported weak association or inconsistent results [27][28][29][30][31]. Recently, there has been an increased interest in the possible relationship between cortical bone density and severity of non-vertebral fractures [32][33][34]. Xie et al [33] found that cortical bone density measured with peripheral quantitative computer tomography was lower in patients with displaced than those with non-displaced distal radius fractures but no difference was found in femoral neck and lumbar spine DXA-measured BMD.…”

Bone Microarchitecture and Distal Radius Fracture Pattern Complexity

“…Pattern complexity of DRFs can be assessed using a classification system such as the AO/OTA classification. It is hypothesized that bone microarchitecture and strength are associated with the pattern complexity of the fracture . Decreased bone mineral density (BMD) has been described as a contributor to the peak in incidence rates of distal radius fractures (DRFs) at the age of 50–60 years .…”

“…It is hypothesized that bone microarchitecture and strength are associated with the pattern complexity of the fracture . Decreased bone mineral density (BMD) has been described as a contributor to the peak in incidence rates of distal radius fractures (DRFs) at the age of 50–60 years . Clayton et al found a nonsignificant trend toward a higher BMD in partially articular (B) and complete articular (C) fractures compared to complete extra‐articular (A) fractures.…”