Relationship between bone mineral density of the distal radius and ulna and fracture characteristics 1 ,

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Abstract

Purpose

This study was designed to elucidate the different decrease patterns of bone mineral density (BMD) in the distal tenth and third of the radius and ulna that influence the incidence of fractures, the fracture type, and redisplacement after closed reduction and casting.

Methods

The BMD of 1024 healthy women and 86 women treated for distal radius and ulna fracture was measured in the distal tenth and distal third zones of the radius and ulna (termed R10, R3, U10, and U3, respectively) using dual-energy x-ray absorptiometry. The BMD in the fracture group was compared with age-matched BMD in the nonfracture group. The relationship between BMD, type of fracture, and radiographic parameters (radial length, radial inclination, and palmar tilt) determined after closed reduction and at bone union were examined.

Results

The BMD of the distal radius in zones R10 and R3 in the fracture group were significantly lower than those in the nonfracture group among subjects older than 80 years, whereas the BMD in the U10 and U3 in the fracture group were lower than those in the nonfracture group among subjects aged 50 to 59 years. No significant difference in the mean BMD in any of the fracture group subjects was found, irrespective of the fracture pattern. A significant correlation was found between the BMD in the R10 and radial length measured at bone union and between radial length measured at bone union and RL measured after closed reduction. The radial length, radial inclination, and palmar tilt measured at bone union correlated significantly with each other.

Conclusions

The BMD in the R10 and R3 are potential indicators of a distal radius fracture in women over 80 years old, whereas the U10 and U3 are indicators of an ulnar styloid fracture in women in their fifties. In addition the distal radius (R10) is an important prognostic parameter of possible deformity of the radius after closed reduction and casting.

Section snippets

Subjects

For the control group, we used 1024 women (age range, 50–94 years; average, 70.4 years) who visited our hospitals during a period of 3 years and 4 months for a periodic medical checkup or for treatment of degenerative musculoskeletal diseases (mainly of the knee and spine). During this same period, a total of 88 women were treated for distal radius fracture in our hospitals. Two out of 88 cases were excluded from the study because they stopped attending our hospitals during the follow-up

Changing of BMD with age

BMD changed in the radius and ulna in the distal tenth and third parts with aging and showed a similar decreasing pattern in all age groups (Fig. 2). BMD decreased in this patient population from the early fifties onward, rapidly decreased until the mid sixties, and continued to decrease gradually into the age of 90.

Comparison of BMD in the nonfracture and fracture groups

The number of cases in the nonfracture and the fracture groups is shown in Table 1. The BMD in the distal third was higher in the ulna than in the radius, although the BMD in the

Discussion

We observed in this study that BMD in women decreases rapidly from the early fifties until mid sixties, and continues to decrease gradually into the age of 90 in both the distal tenth and third parts of the radius and ulna. This decrease pattern of BMD fits well with that of postmenopausal women; it is a rapid early bone loss that attenuates within 6 years after the onset of menopause and is followed by a further bone loss possibly related to the age-related increase of parathyroid hormone

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  • Cited by (0)

    This work has been partially supported by CREST of the Japan Science and Technology (JST).

    1

    No benefits in any form have been received or will be received by a commercial party related directly or indirectly to the subject of this article.

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