Low-energy distal radius fractures in middle-aged and elderly men and women—the burden of osteoporosis and fracture risk

Øyen, Jannike; Gjesdal, Clara Gram; Brudvik, Christina; Hove, Leiv M.; Apalset, Ellen M; Gulseth, H.C.; Haugeberg, Glenn

doi:10.1007/s00198-009-1068-x

Cited by 58 publications

(36 citation statements)

References 41 publications

(65 reference statements)

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“…A decade later, that number is essentially unchanged at 20%. Similar rates of treatment are seen after osteoporotic wrist fractures [70]. Patients who have suffered a fragility fracture are at increased risk for future fracture and thus all deserve an assessment for osteoporosis and other causes of impaired bone quality and appropriate treatment.…”

Section: Diagnosis and Treatment Of Diseases Associated With Impairedmentioning

confidence: 83%

“…The incidence is higher in patients considered at lower risk for osteoporosis, with up to two-thirds of men and premenopausal women with osteoporosis demonstrating a secondary cause contributing to their disease [70]. Secondary causes of osteoporosis vary widely from autoimmune disease, glucocorticoid therapy, malignancy, hormonal suppressive agents for breast or prostate cancer, hypercalciuria, HIV, celiac disease, and diseases of malabsorption [24].…”

Section: Diagnosis and Treatment Of Diseases Associated With Impairedmentioning

confidence: 99%

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Short-term and Long-term Orthopaedic Issues in Patients With Fragility Fractures

Bukata

Kates

O’Keefe

2011

Clinical Orthopaedics &Amp; Related Research

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Background Patients with impaired bone quality who suffer a fragility fracture face substantial challenges in both their short-and long-term care. In addition to poor bone quality, many of these patients have multiple medical comorbidities that alter their surgical risk and affect their ultimate functional recovery. Some medical issues can contribute to the altered bone quality and must be addressed to prevent future fractures. Questions/purposes This review summarizes the modifications in perioperative management and fracture fixation in patients with common fragility fractures who have impaired bone quality. It also summarizes the postoperative diagnosis and treatment of secondary causes of impaired bone quality in these patients. Methods We performed a PubMed search, and literature published after 2000 was prioritized, with the exception of benchmark clinical trial studies published before 2000. Results Patients with altered bone quality require rapid perioperative management of multiple medical comorbidities. Implant selection in patients with poor quality bone should permit early weightbearing, and constructs should maximize surface area contact with the remaining bone. Long-term diagnosis and treatment of other disease states contributing to poor bone quality (vitamin D deficiency/ insufficiency, hypothyroidism, hyperthyroidism, hyperparathyroidism, Cushing's disease, and hypogonadism) must occur to minimize the chances of future fractures. Conclusions Recognition of patients with impaired bone quality and proper treatment of their special needs in both the short and long term are essential for their best opportunity for maximal functional recovery and prevention of future fractures.

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Section: Diagnosis and Treatment Of Diseases Associated With Impairedmentioning

confidence: 83%

Section: Diagnosis and Treatment Of Diseases Associated With Impairedmentioning

confidence: 99%

Short-term and Long-term Orthopaedic Issues in Patients With Fragility Fractures

Bukata

Kates

O’Keefe

2011

Clinical Orthopaedics &Amp; Related Research

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“…157 The rate is even higher in men with osteoporosis and premenopausal women with osteoporosis (50%-60%) and in patients who have suffered a hip fracture (>80%). 158 Patients undergoing assessment for osteoporosis, particularly those who have had a fragility fracture, should have additional laboratory testing to assess for these secondary causes. Serum calcium, 25-hydroxy vitamin D, intact parathyroid hormone, thyroidstimulating hormone, and 24-hour urine calcium levels should be a part of the osteoporosis assessment.…”

Section: Secondary Prevention Of Fragility Fractures (S Bukata) Basimentioning

confidence: 99%

A Guide to Improving the Care of Patients With Fragility Fractures

Bukata

DiGiovanni

Friedman

et al. 2011

Geriatr Orthop Surg Rehabil

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ForewordFragility fractures, low-energy injuries that occur from a fall from a standing or lower height, represent a serious public health problem. After age 50, the lifetime risk of having a fragility fracture is 33% for an American woman and 20% for a man. 1 In the United States, 2.1 million people will suffer a fragility fracture each year.1 The incidence of fragility fractures increases steeply after age 65.2 Osteoporosis is present in most patients with a fragility fracture.Hip fractures are the most serious in terms of cost and morbidity. The average cost of inpatient care for a hip fracture in 2005 was $33 962.3 The lifetime risk of having a hip fracture is 6% for men and 17.5% for women. Although the mortality risk after a hip fracture is much higher for a man, a woman's risk of dying from a hip fracture is high and exceeds the lifetime risk of death from breast cancer, uterine cancer, and ovarian cancer combined. For those who survive after a hip fracture, most do not regain their preinjury level of function, and 30% lose their independence. This loss of independence is greatly feared by patients and is very costly to patients and society.Although a hip fracture may have the most serious consequences, other bones, such as the wrist, shoulder, ankle, pelvis, and spine, frequently fracture in the osteoporotic patient. For example, the lifetime risk of a forearm or vertebral compression fracture is 16% and 15.6%, respectively, for a woman and 2.5% and 5%, respectively, for a man. 4 These statistics clearly show that fragility fractures are a major problem facing American society today, 5 and the care of such fractures presents an even greater challenge, in part because the quality of care delivered in the United States varies widely, even within one region. Many such fractures are treated in an outpatient setting, although some may be treated in the inpatient hospital setting. However, the quality of care for seniors with fragility fractures receives relatively little attention. In 2004, the United States Surgeon General issued a comprehensive report calling for health professionals to make significant improvements in our nation's bone health, and an improvement in the system and methods of care was suggested. 5There has been little written on the subject of improving the system of care delivery in the United States.The goals of this blue book are to review the methods used in inpatient and outpatient care, as well as rehabilitation of the patient with a fragility fracture. We discuss evidence-based best care models and, where evidence is lacking, present expert opinions in an effort to improve the standard and the quality of care for the patient with a fragility fracture. We hope that this monograph will provide guidance to physicians, nurses, rehabilitation therapists, other health care providers, and administrators.Stephen L. Kates, MD Editor-in-Chief Simon C. Mears, MD, PhD

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“…In women, the incidence is four times higher than in men, starting to increase after menopause and reaching its peak between the age of 60 and 70 [3,4]. It is linked to low-bone density due to osteoporosis [5,6].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of combined physical and occupational therapy in patients with conservatively treated distal radius fracture: randomized controlled trial

Filipova

Lonzarić

Papež

2015

Wien Klin Wochenschr

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Low-energy distal radius fractures in middle-aged and elderly men and women—the burden of osteoporosis and fracture risk

Cited by 58 publications

References 41 publications

Short-term and Long-term Orthopaedic Issues in Patients With Fragility Fractures

Short-term and Long-term Orthopaedic Issues in Patients With Fragility Fractures

A Guide to Improving the Care of Patients With Fragility Fractures

Efficacy of combined physical and occupational therapy in patients with conservatively treated distal radius fracture: randomized controlled trial

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