Clinical Efficacy of a Fragility Care Program in Distal Radius Fracture Patients

Sarfani, Shumaila; Scrabeck, Tyson L.; Kearns, Ann E.; Berger, Richard A.; Kakar, Sanjeev

doi:10.1016/j.jhsa.2014.01.009

Cited by 33 publications

(19 citation statements)

References 23 publications

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“…At our institution, 31% of patients who were managed for a distal radial fracture underwent CT as part of their evaluation. Although this number is low for a screening test, it is incidentally higher than published utilization rates of other osteoporosis screening tools such as DXA 2,6,11,12 . Given that only a minority of patients underwent CT for the management of a distal radial fracture, it is unknown whether our fracture cohort is truly representative of the larger distal radial fracture cohort.…”

Section: Discussionmentioning

confidence: 79%

Opportunistic Osteoporosis Screening— Gleaning Additional Information from Diagnostic Wrist CT Scans

Schreiber

Gausden

Anderson

et al. 2015

The Journal of Bone and Joint Surgery

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HU measurements can be obtained from any diagnostic CT scan using modern software programs and can be obtained by physicians in the office setting with minimal effort and at no additional cost or radiation exposure to the patient. Regardless of imaging indications, we suggest that patients with HU values below the identified thresholds be considered for further metabolic bone disease work-up, such as additional imaging, laboratory assessments, the initiation of osteoporosis treatment, or appropriate referral.

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Section: Discussionmentioning

confidence: 79%

Opportunistic Osteoporosis Screening— Gleaning Additional Information from Diagnostic Wrist CT Scans

Schreiber

Gausden

Anderson

et al. 2015

The Journal of Bone and Joint Surgery

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“…There is generally an interval of approximately 10 years between DRF and proximal femoral fracture (Robinson et al, 2002, Schousboe et al, 2005). In the year after a DRF a patient is regularly seen by a healthcare provider, making this an opportunity to address prevention, including osteoporosis screening and treatment, gait training, exercise and alteration of risk-prone environments at both the individual and community level (Carande-Kulis et al, 2015, Grahn Kronhed et al, 2006, Guse et al, 2015, Sarfani et al, 2014, Tosi et al, 2008). As healthcare resources dwindle, prevention programmes will become more important.…”

Section: Discussionmentioning

confidence: 99%

Mortality after distal radial fractures in the Medicare population

Shauver

Zhong

Chung

2015

J Hand Surg Eur Vol

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The occurrence of a low energy fracture of the distal radius increases the risk for another, more serious fracture such as a proximal femoral fracture. Early mortality after proximal femoral fracture has been widely studied, but the association between distal radial fracture and mortality is unknown. The date of death for all Medicare beneficiaries who sustained an isolated distal radial fracture in 2007 was determined using Medicare Vital Statistics files. The adjusted mortality rate for each age-sex group was calculated and compared with published US mortality tables. Distal radial fractures were not associated with an increased mortality rate. In fact, beneficiaries had a significantly lower mortality rate after distal radial fractures than the general population. This may be related to the injured beneficiaries’ involvement in the healthcare system. Mortality rate did not vary significantly based on time from injury. Our results indicate that any mortality is unlikely to be attributable to the distal radial fracture or its treatment. Level of Evidence: III

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“…Specifically, DRFs are associated with increased risk of subsequent hip and vertebral fractures, which are directly related to increased mortality [10,11,54,55]. Despite this association, only 21.3% of patients with DRF undergo bone mineral density (BMD) evaluation, and fewer than 30% ever initiate medical treatment [47,56]. The importance of early osteoporosis screening and diagnosis following a fracture cannot be overstated.…”

Section: Osteoporosis Screening and Treatmentmentioning

confidence: 99%

Considerations in the Treatment of Osteoporotic Distal Radius Fractures in Elderly Patients

Ostergaard

Hall

Rozental

2019

Curr Rev Musculoskelet Med

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Purpose of Review With the incidence of distal radius fractures increasing in the elderly population, we sought to summarize the current orthopedic and medical management of these fractures in the elderly osteoporotic population. Recent Findings The number of osteoporotic patients undergoing surgical fixation for distal radius fractures has increased in recent years. This is likely due to the improved outcomes seen with volar locking plates, as well as an increase in the number of fellowship-trained hand surgeons. Despite this potential improvement in acute fracture management, a majority of these patients are underdiagnosed and undertreated for their underlying osteoporosis or endocrinopathies. The implementation of fracture liaison services and the ability of the treating orthopedist to recognize this gap in patient care result in a higher number of patients initiating appropriate treatment. Summary It is vital that when discussing acute fracture management, a thorough discussion is had with patients regarding functional outcome and the benefits of both surgical and non-operative management. As these fractures become more prevalent and a greater percentage undergo surgical intervention, the economic burden of distal radius fractures will continue to rise. It is imperative that the treating surgeon view these fractures as sentinel events that are predictive of future hip and vertebral fractures. While relatively new, the use of fracture liaison services to help aide in proper screening and treatment of osteoporotic patients is of great value. Non-pharmacologic therapy such as physical therapy, smoking and alcohol cessation programs, and dietary modifications are crucial in treating patients with osteoporosis. While bisphosphonates remain the first-line treatment in patients with osteoporosis, novel therapies show promise for future use.

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Clinical Efficacy of a Fragility Care Program in Distal Radius Fracture Patients

Cited by 33 publications

References 23 publications

Opportunistic Osteoporosis Screening— Gleaning Additional Information from Diagnostic Wrist CT Scans

Opportunistic Osteoporosis Screening— Gleaning Additional Information from Diagnostic Wrist CT Scans

Mortality after distal radial fractures in the Medicare population

Considerations in the Treatment of Osteoporotic Distal Radius Fractures in Elderly Patients

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