Osteoporosis care after distal radius fracture reduces subsequent hip or spine fractures:​ a 4-year longitudinal study

Shin, Y. H.; Hong, W. K.; Kim, J.; Gong, H. S.

Affiliations

¹Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

²Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea

³Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoungnam-si, South Korea

Abstract and keywords

Summary: We evaluated whether active osteoporosis care in patients experiencing their first distal radius fracture (DRF) reduces subsequent hip or spine fractures by comparing two cohorts. The incidence of subsequent fractures was significantly lower in the active care cohort than the other cohort in 4-year follow-up.

Purpose: Studies show that osteoporosis care in patients with osteoporotic fracture reduces subsequent fractures, but the impact of such active care in patients with distal radius fracture (DRF) has not been well studied. We evaluated how much osteoporosis care in patients experiencing their first DRF can reduce subsequent hip or spine fractures at 4-year follow-up.

Methods: Active osteoporosis care by orthopedic surgeons for patients with DRF started from September 2009 at our institution, thus we had a unique opportunity to compare the two cohorts: pre-involvement (PreI) group (DRF before September 2009) and post-involvement (PostI) group (DRF from September 2009). We compared the two cohorts for subsequent hip or spine fracture incidence in the 4 years following DRF.

Results: Overall, 1057 patients with a DRF (85% women; mean age, 70 years) were studied, of whom 205 patients were in PreI group and 852 in PostI group. Subsequent fractures occurred in 27 patients (2.6%), with a mean interval of 29 months after DRF. The incidence was significantly lower in the PostI group than in the PreI group (1.9% vs. 5.4%, p = 0.004), especially in hip fractures (0.4% vs. 2.9%, p = 0.002). The relative risk reduction was 65% for all subsequent fractures and 86% for hip fractures.

Conclusion: This study demonstrates that active osteoporosis care in patients with DRF significantly reduces subsequent fracture incidence even for the 4-year follow-up period. These findings add an evidence for the current proactive osteoporosis care programs such as fracture liaison services.

Level of evidence: Therapeutic level III.

Keywords: Distal radius fracture; Hip fracture; Osteoporosis care; Subsequent fracture

Links

DOI: 10.1007/s00198-020-05410-3

PubMed: 32300839

WoS: 000548231300006

History

Received: 2020-02-16

Accepted: 2020-04-03

Online: 2020-04-16

Cited Works (4)

Year	Entry
2019	Bouxsein ML, Eastell R, Lui L-Y, Wu LA, de Papp AE, Grauer A, Marin F, Cauley JA, Bauer DC, Black DM; FNIH Bone Quality Project. Change in bone density and reduction in fracture risk: a meta-regression of published trials. J Bone Miner Res. April 2019;34(4):632-642.
2017	Khosla S, Cauley JA, Compston J, Kiel DP, Rosen C, Saag KG, Shane E. Addressing the crisis in the treatment of osteoporosis: a path forward. J Bone Miner Res. March 2017;32(3):424-430.
2007	Burge R, Dawson‐Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis‐related fractures in the United States, 2005–2025. J Bone Miner Res. March 2007;22(3):465-475.
2016	Adler RA, Fuleihan GE-H, Bauer DC, Camacho PM, Clarke BL, Clines GA, Compston JE, Drake MT, Edwards BJ, Favus MJ, Greenspan SL, McKinney R Jr, Pignolo RJ, Sellmeyer DE. Managing osteoporosis in patients on long-term bisphosphonate treatment: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2016;31(1):16-35.

Cited By (2)

Year	Entry
2022	Hwang JS, Lee S, Gong HS. The impact of acute fracture on interpretation of bone turnover marker measurements for patients starting anti-resorptive therapies. Bone. January 2022;154:116199.
2022	Vranken L, de Bruin IJA, Driessen AHM, Geusens PPM, Eisman JA, Center JR, van der Velde RY, Janzing HMJ, Kaarsemaker S, van den Bergh JP, Wyers CE. Decreased mortality and subsequent fracture risk in patients with a major and hip fracture after the introduction of a fracture liaison service: a 3-year follow-up survey. J Bone Miner Res. October 2022;37(10):2025-2032.