The Epidemiology of Distal Radius Fractures

Nellans, Kate W.; Kowalski, Evan; Chung, Kevin C.

doi:10.1016/j.hcl.2012.02.001

Cited by 685 publications

(521 citation statements)

References 90 publications

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“…Distal radius fractures are very common in osteoporosis patients [59] . The most common cause of the distal radial fracture is a fall on the outstretched hand in people with normal or low bone mineral density [60] .…”

Section: Distal Radiusmentioning

confidence: 99%

Bone three-dimensional microstructural features of the common osteoporotic fracture sites

Chen

Kubo

2014

WJO

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Osteoporosis is a common metabolic skeletal disorder characterized by decreased bone mass and deteriorated bone structure, leading to increased susceptibility to fractures. With aging population, osteoporotic fractures are of global health and socioeconomic importance. The three-dimensional microstructural information of the common osteoporosis-related fracture sites, including vertebra, femoral neck and distal radius, is a key for fully understanding osteoporosis pathogenesis and predicting the fracture risk. Low vertebral bone mineral density (BMD) is correlated with increased fracture of the spine. Vertebral BMD decreases from cervical to lumbar spine, with the lowest BMD at the third lumbar vertebra. Trabecular bone mass of the vertebrae is much lower than that of the peripheral bone. Cancellous bone of the vertebral body has a complex heterogeneous three-dimensional microstructure, with lower bone volume in the central and anterior superior regions. Trabecular bone quality is a key element to maintain the vertebral strength. The increased fragility of osteoporotic femoral neck is attributed to low cancellous bone volume and high compact porosity. Compared with age-matched controls, increased cortical porosity is observed at the femoral neck in osteoporotic fracture patients. Distal radius demonstrates spatial inhomogeneous characteristic in cortical microstructure. The medial region of the distal radius displays the highest cortical porosity compared with the lateral, anterior and posterior regions. Bone strength of the distal radius is mainly determined by cortical porosity, which deteriorates with advancing age. Key words: Osteoporosis; Fracture; Microstructure; Trabecular bone; Cortical bone; Vertebra; Femoral neck; Distal radius Core tip: The most common sites of the osteoporotic fractures include the vertebra, femoral neck and distal radius, where the microstructural information is a key for fully understanding osteoporosis pathogenesis and improving the prediction of fracture risk. Vertebral strength is mostly preserved by trabecular bone, which is microstructurally inhomogeneous, with lower bone volume in the central and anterior superior regions. Increased fragility of osteoporotic femoral neck is attributed to low cancellous bone volume and high compact porosity. Distal radius shows significant variations in cortical porosity, which is the major element attributed to bone strength of the distal radius.

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Section: Distal Radiusmentioning

confidence: 99%

Bone three-dimensional microstructural features of the common osteoporotic fracture sites

Chen

Kubo

2014

WJO

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“…Economic costs of distal radius fractures also are substantial-direct costs of care are more than USD 480 million in the United States annually; more than USD 170 million of these costs are borne by publically funded Medicare [39,43]. As the population continues to age, the burden of distal radius fractures and the costs of care are expected to increase [33]. Unfortunately, the treatments for these injuries is controversial [22].…”

Section: Introductionmentioning

confidence: 99%

Are Volar Locking Plates Superior to Percutaneous K-wires for Distal Radius Fractures? A Meta-analysis

Chaudhry

Kleinlugtenbelt

Mundi

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Distal radius fractures are common, costly, and increasing in incidence. Percutaneous K-wire fixation and volar locking plates are two of the most commonly used surgical treatments for unstable dorsally displaced distal radius fractures. However, there is uncertainty regarding which of these treatments is superior. Questions/purposes We performed a meta-analysis of randomized controlled trials to determine whether patients treated with volar locking plates (1) achieved better function (2) attained better wrist motion, (3) had better radiographic outcomes, and (4) had fewer complications develop than did patients treated with K-wires for dorsally displaced distal radius fractures. Methods We performed a comprehensive search of MEDLINE (inception to 2014, October Week 2), EMBASE (inception to 2014, Week 42), and the Cochrane Central Register of Controlled Trials to identify relevant randomized controlled trials; we supplemented these searches with manual searches. We included studies of extraarticular and intraarticular distal radius fractures. Adjunctive external fixation was acceptable as long as the intent was to use only K-wires where possible and external fixation was used in less than 25% of the procedures. We considered a difference in the DASH scores of 10 as the minimal clinically important difference. We performed quality assessment with the Cochrane Risk of Bias tool and evaluated the strength of recommendations using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Seven randomized trials with a total of 875 participants were included in the meta-analysis. Results Patients treated with volar locking plates had slightly better function than did patients treated with K-wires as measured by their DASH scores at 3 months (mean difference [MD], 7.5; 95% CI, 4.4-10.6; p \ 0.001) and 12 months (MD, 3.8; 95% CI, 1.2-6.3; p = 0.004). Neither of these differences exceeded the a priori-determined threshold for clinical importance (10 points). There was a small early advantage in flexion and supination in the volar locking plate group (3.7°[95% CI, 0.3°-7.1°; p = 0.04] and 4.1°[95% CI, 0.6°-7.

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“…[1] Most distal radius fractures can be treated by closed reduction and plaster immobilization, which often sis supported the use of external fixation. [9] Choices of treatment have been compared in many randomized controlled trials (RCTs).…”

Section: Introductionmentioning

confidence: 99%

Internal fixation versus conservative treatment for displaced distal radius fractures: a meta-analysis of randomised controlled trials

Yu¹

2015

Ulus Travma Acil Cerrahi Derg

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The Epidemiology of Distal Radius Fractures

Cited by 685 publications

References 90 publications

Bone three-dimensional microstructural features of the common osteoporotic fracture sites

Bone three-dimensional microstructural features of the common osteoporotic fracture sites

Are Volar Locking Plates Superior to Percutaneous K-wires for Distal Radius Fractures? A Meta-analysis

Internal fixation versus conservative treatment for displaced distal radius fractures: a meta-analysis of randomised controlled trials

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