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

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.