Distal radius fracture, a predecessor to hip fracture in osteoporotic elderlies: not just a notion but a codified itinerary-Long term follow up study of 30 years (1985-2015).

Abstract

Purpose: This study quantifies the long-term absolute risk of hip fracture in older individuals following distal radius fracture and explores gender-related differences in the correlation between fracture history and future fracture risk associations.

Methods: A retrospective cohort study was conducted using medical records from Government Rural District hospital from 1985 to 2015, where in the author served as a full time in-house orthopedic surgeon in the same hospital during this era. All patients aged ≥ 50 years with radiographically confirmed distal radius fractures were followed for subsequent hip fractures. Cox proportional hazards regression was used to estimate hazard ratios with 95% confidence intervals, adjusting for age, sex, and their interactions.

Results: Among 2,484 patients with distal radius fractures, 396 subsequently developed hip fractures over 30 years of follow-up. The mean interval from distal radius fracture to hip fracture ranged from 2.4 to 5.2 years across age groups (p < 0.0001). Men demonstrated higher absolute risk than women, with hazard ratios of 2.24 (95% CI 1.89-2.65) for men and 1.94 (95% CI 1.62-2.32) for women. Risk was particularly elevated in men aged 50-70 years (RH: 2.88; 95% CI 2.41-3.44).

Conclusion: Distal radius fractures confer substantial long-term hip fracture risk, with men showing higher absolute risk than women. These findings support using distal radius fractures as sentinel events for implementing secondary fracture prevention strategies, substantiate the notion that distal radius fracture serves as an early and sensitive indicator of male skeletal fragility.