Postural Stability in Older Adults with a Distal Radial Fracture

• Published in: Journal of bone and joint surgery. American volume 2016-07, Vol.98 (14), p.1176-1182
• Main Authors: Louer, Craig R., Boone, Sean L., Guthrie, Andre K., Motley, John R., Calfee, Ryan P., Wall, Lindley B.
• Format: Article
• Language: English
• Subjects: Aged; Body Mass Index; Female; Health Status; Humans; Male; Postural Balance - physiology; Radius Fractures - physiopathology; Scientific
• ISSN: 0021-9355; 1535-1386
• DOI: 10.2106/JBJS.15.00963

The physical risk factors leading to distal radial fractures are poorly understood. The goal of this study was to compare postural stability between older adults with and without a prior distal radial fragility fracture. This case-control evaluation was performed at a single tertiary institution. The fracture cohort comprised 23 patients treated for a low-energy distal radial fracture within 6 to 24 months prior to this study. Twenty-three age and sex-matched control participants, without a prior fragility fracture, were selected from an outpatient clinic population. All participants completed a balance assessment with a computerized balance platform device. Dynamic motion analysis (DMA) scores ranging from 0 to 1,440 points are produced, with lower scores indicating better postural stability. Participants also completed validated questionnaires for general health quality (EuroQol-5D-3L [EQ-5D-3L]) and physical activity (Physical Activity Scale for the Elderly [PASE]) and comprehensive health and demographic information including treatment for compromised balance or osteoporosis. Statistical analysis compared data between cases and controls using either the Student t test or the Mann-Whitney U test. There were no significant differences (p > 0.05) in age, sex, body mass index, physical activity score, or EQ-5D-3L general health visual analog scale score between participants with or without prior distal radial fracture. The fracture cohort demonstrated poorer balance, with higher DMA scores at 933 points compared with 790 points for the control cohort (p = 0.008). Nineteen patients (83%) in the fracture cohort reported having dual x-ray absorptiometry (DXA) scans within 5 years prior to this study, but only 2 patients (9%) had ever been referred for balance training with physical therapy. Older adults who sustain low-energy distal radial fractures demonstrate impaired postural stability compared with individuals of a similar age who have not sustained such fractures. Following a distal radial fracture, these patients may benefit from interventions to improve postural stability. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.