High prevalence of female osteoporosis and male osteopenia in patients aged more than 55 years old with upper limb fracture

Abstract

Introduction: According to literature and osteoporosis treatment guidelines, both men and women with distal radius fractures (DRFx) and proximal humerus fractures (PHFx) caused by low-energy trauma may have undetected osteoporosis. Although upper limb fracture is a known predictor of subsequent osteoporotic fracture, the rates of prompt bone mineral density (BMD) evaluation and antiosteoporotic management in these patients remains much lower than those in patients with hip or spine fractures. Purpose: To evaluate the awareness of the physician for survey osteoporosis and to identify the association of the aforementioned fractures after falls with osteoporosis based on BMD estimated through dual-energy X-ray absorptiometry. Methods: We collected the parameters, including ethnicity, comorbidities, age, sex, and BMD data of the patients aged ≥ 55 years who sustained DRFx or PHFx and their BMD examination rates as physician awareness rate of possible osteoporosis. The incidence of osteoporosis among patients with these fractures was compared and associated risk factors were identified. Results: The physician awareness rates were 65.1% in DRFx and 66.0% in PHFx. Four hundred and twenty-one patients with DRFx and 219 patients with PHFx were included. Of the patients, 239 were male and 401 were female, and their mean age was 67.1 ± 6.5 years. The osteoporosis rates were 38.0% and 46.6% in DRFx and PHFx. No patient aged more than 70 years had normal BMD in our study group. Most female patients had osteoporosis, whereas most male patients had osteopenia. 7.7% of the patients had normal T scores and only 24.6% of the patients with osteoporosis were undergoing regular antiosteoporotic treatment and follow-up. Those with PHFx had a significantly higher osteoporosis risk than did those with DRFx. Conclusion: Osteoporosis awareness and treatment are crucial after distal radius or PHFx in addition to hip fractures, particularly for female and older patients.