Relationship of bone mineral density of spine and femoral neck to distal radius fracture stability in patients over 65

Abstract

Purpose: We hypothesized that an increasing degree of osteopenia in the femoral neck and lumbar spine would be associated with loss of reduction after closed manipulation and splinting of distal radius fractures in patients over 65 years of age.

Methods: We performed a retrospective review, evaluating 78 patients with displaced distal radius fractures managed with closed reduction and splinting. T-scores from the lumbar spine and femoral neck were recorded from dual-energy x-ray absorptiometry scans performed either within 1 year before or after injury. Volar tilt, radial height, radial inclination, and ulnar variance were evaluated from the initial fracture, postreduction, and final follow-up radiographs. We calculated the percentage of reduction maintained regarding reduction variable. We correlated T-scores of the lumbar spine and femoral neck with the percentage of retained reduction.

Results: We found no correlation between T-scores of the lumbar spine or femoral neck and the amount of reduction lost throughout the healing process of distal radius fractures with respect to volar tilt, radial height, radial inclination, or ulnar variance. Reduction was of no anatomical benefit in 53% to radial height, 44% to radial inclination, and 54% to ulnar variance.

Conclusions: There appears to be no relationship between bone mineral density, based on T-scores of the lumbar spine and femoral neck, and the ability to maintain reduction after closed manipulation and splinting of displaced distal radius fractures in patients over 65 years of age.

Type of study/level of evidence: Prognostic III.

Keywords: Bone mineral density; closed reduction; distal radius fracture.