Patient-related outcome, fracture displacement and bone mineral density following distal radius fracture in young and older men
(2020) In BMC Musculoskeletal Disorders 21(1).- Abstract
Background: Distal radius fractures can adversely affect wrist function; for men with this fracture, the role played by fracture severity, age and osteoporosis on fracture outcome has not been sufficiently studied. Objective: To describe patient-reported outcome and the association with bone integrity, fracture severity and future fracture risk among young and older men with distal radius fracture. Methods: This prospective study includes 133 men with acute distal radius fracture, mean age 54 (range 21–88), who were followed for 12 months. They were categorized as younger (< 65) and older (65+). Main outcome was DASH (Disability of the Arm, Shoulder and Hand) at 12 months; DASH > 15 was defined as poor outcome. Fractures were... (More)
Background: Distal radius fractures can adversely affect wrist function; for men with this fracture, the role played by fracture severity, age and osteoporosis on fracture outcome has not been sufficiently studied. Objective: To describe patient-reported outcome and the association with bone integrity, fracture severity and future fracture risk among young and older men with distal radius fracture. Methods: This prospective study includes 133 men with acute distal radius fracture, mean age 54 (range 21–88), who were followed for 12 months. They were categorized as younger (< 65) and older (65+). Main outcome was DASH (Disability of the Arm, Shoulder and Hand) at 12 months; DASH > 15 was defined as poor outcome. Fractures were classified and radiographic displacement identified at initial presentation and follow-up. BMD was measured and FRAX 10-year probability of fracture calculated. Results: Disability was higher in older men (DASHmedian 10 vs 2; p = 0.002); a clinically meaningful difference (ΔDASH = 10, p = 0.017) remained after adjustment for displacement, fracture classification and treatment method. Almost 50% of older men vs 14% in younger had poor outcome, p < 0.001. Bone mineral density did not independently predict outcome. Older men with a displaced fracture at initial presentation had greater disability (DASHmedian, IQR 45, 14;73) and risk of fracture (FRAXmajor osteoporotic 14, 8;21). Conclusion: Men over the age of 65 with a distal radius fracture are more likely to have post-fracture disability regardless of radiographic appearance. Fracture displacement, indicating impaired bone strength, is also more common and associated with an increased risk of fracture within 10-years. Secondary fracture prevention should therefore be considered in men presenting with distal radius fracture.
(Less)
- author
- Egund, Lisa LU ; McGuigan, Fiona E. LU ; Egund, Niels ; Besjakov, Jack LU and Åkesson, Kristina E. LU
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- BMD, patient-reported outcome, Displacement, Distal radius fracture, FRAX, Function, Men
- in
- BMC Musculoskeletal Disorders
- volume
- 21
- issue
- 1
- article number
- 816
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:85097283178
- pmid:33287782
- ISSN
- 1471-2474
- DOI
- 10.1186/s12891-020-03843-9
- language
- English
- LU publication?
- yes
- id
- 70b5337a-764c-4a25-a23a-bb32b0c78048
- date added to LUP
- 2020-12-15 07:24:11
- date last changed
- 2024-09-19 11:48:24
@article{70b5337a-764c-4a25-a23a-bb32b0c78048, abstract = {{<p>Background: Distal radius fractures can adversely affect wrist function; for men with this fracture, the role played by fracture severity, age and osteoporosis on fracture outcome has not been sufficiently studied. Objective: To describe patient-reported outcome and the association with bone integrity, fracture severity and future fracture risk among young and older men with distal radius fracture. Methods: This prospective study includes 133 men with acute distal radius fracture, mean age 54 (range 21–88), who were followed for 12 months. They were categorized as younger (< 65) and older (65+). Main outcome was DASH (Disability of the Arm, Shoulder and Hand) at 12 months; DASH > 15 was defined as poor outcome. Fractures were classified and radiographic displacement identified at initial presentation and follow-up. BMD was measured and FRAX 10-year probability of fracture calculated. Results: Disability was higher in older men (DASH<sub>median</sub> 10 vs 2; p = 0.002); a clinically meaningful difference (ΔDASH = 10, p = 0.017) remained after adjustment for displacement, fracture classification and treatment method. Almost 50% of older men vs 14% in younger had poor outcome, p < 0.001. Bone mineral density did not independently predict outcome. Older men with a displaced fracture at initial presentation had greater disability (DASH<sub>median</sub>, IQR 45, 14;73) and risk of fracture (FRAX<sub>major osteoporotic</sub> 14, 8;21). Conclusion: Men over the age of 65 with a distal radius fracture are more likely to have post-fracture disability regardless of radiographic appearance. Fracture displacement, indicating impaired bone strength, is also more common and associated with an increased risk of fracture within 10-years. Secondary fracture prevention should therefore be considered in men presenting with distal radius fracture.</p>}}, author = {{Egund, Lisa and McGuigan, Fiona E. and Egund, Niels and Besjakov, Jack and Åkesson, Kristina E.}}, issn = {{1471-2474}}, keywords = {{BMD, patient-reported outcome; Displacement; Distal radius fracture; FRAX; Function; Men}}, language = {{eng}}, number = {{1}}, publisher = {{BioMed Central (BMC)}}, series = {{BMC Musculoskeletal Disorders}}, title = {{Patient-related outcome, fracture displacement and bone mineral density following distal radius fracture in young and older men}}, url = {{http://dx.doi.org/10.1186/s12891-020-03843-9}}, doi = {{10.1186/s12891-020-03843-9}}, volume = {{21}}, year = {{2020}}, }