Bone Mineral Density is Not Correlated with One-Year Functional Outcome in Distal Radial Fractures: A Preliminary Study

• Published in: European journal of trauma and emergency surgery (Munich : 2007) 2009-06, Vol.35 (3), p.281-286
• Main Authors: Boymans, Tim A. E. J., van Helden, Svenhjalmar, Kessels, Alfons, ten Broeke, René, Brink, Peter R. G.
• Format: Article
• Language: English
• Subjects: Arms; Bone density; Bones; Clinical outcomes; Critical Care Medicine; Emergency Medicine; Fractures; Intensive; Medical treatment; Medicine; Medicine & Public Health; Older people; Original Article; Osteoporosis; Sports Medicine; Surgery; Surgical Orthopedics; Traumatic Surgery
• ISSN: 1863-9933; 1863-9941
• DOI: 10.1007/s00068-008-8120-y

Introduction: The intrinsic stability of fractures related to soft tissue injury and the comminution of the metaphyseal part of the distal radius influence the chance of secondary displacement in distal radial fractures treated conservatively. A low bone mineral density may also contribute to this secondary displacement and could therefore play a role in functional outcome. This possible relation between functional outcome and bone mineral density is poorly studied. Patients and Methods: Patients with a unilateral conservatively treated distal radial fracture were assessed one year after their fracture with the DASH score (disabilities of the arm, shoulder and hand) and the Cooney score. Fractures were classified according to the AO classification. Radial inclination, radial shift, radial tilt and ulnar variance were measured on the first and follow-up radiographies. Bone mineral densities of both the hip and lumbar spine were measured by DXA and expressed as T-scores. Results: Fifty-four patients participated in this study (mean age 68 years). Osteoporosis (T-score ≤ –2.5) was present in 20 patients (37%), osteopenia (T-score of –1 to –2.5) in 30 patients (56%), and normal bone density (T-score > –1) in four patients (7%). The distribution of fracture types according to the AO classification showed 32 A-type fractures, eight B-type fractures and 14 C-type fractures. Both univariate linear and multivariate regression analysis with covariates of age, sex, body mass index and AO classification showed no significant correlation between T-score and functional outcome. Conclusion: The functional outcome of conservatively treated distal radial fractures in this study does not correlate with bone mineral density. Therefore, BMD measurement cannot be used to predict functional outcome in these patients.