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2025 ; 16
(ä): 21514593251351180
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Distal Radius Fractures as a Call to Action: Reducing Subsequent Fragility
Fracture Risk Through Early Osteoporosis Therapy
#MMPMID40585865
Armando C
; Fox EJ
; Taylor KF
Geriatr Orthop Surg Rehabil
2025[]; 16
(ä): 21514593251351180
PMID40585865
show ga
PURPOSE: Distal radius fractures (DRF) often serve as the initial indication of
bone mineral disease. This study aims to determine the extent to which the risk
of subsequent fragility fractures can be reduced by initiating anti-osteoporotic
therapy after initial presentation of a DRF. METHODS: This study utilized
TriNetX, an online database with de-identified patient data from 79 US healthcare
organizations. Females above the age of 50 were categorized based on receiving
initial anti-osteoporotic treatment within a year of the DRF. Group
characteristics, antiosteoporosis medications, and bone density evaluations were
analyzed. After propensity matching, the risk of subsequent DRF, hip and
vertebral fractures, as well as incidence of additional DEXA scans from 2004 to
2024 was explored. RESULTS: The Medication (M) group (n = 6709) had a mean age of
69, the No Medication (NM) group (n = 181,065) had a mean age of 65 at the index
incidence. Baseline differences included higher rates of bone density disorders,
inflammatory polyarthropathies, spondylopathies, metabolic disorders, obesity,
malnutrition, and neoplasm in the M group. Notably, 43% of the M group had a
prior DEXA scan compared to 8.7% of the NM group. The most prescribed
anti-osteoporotic medication in the M group was Alendronate (49%). After
propensity matching (n = 6627), the M group had 32% more DEXA scans and were 25%
less likely to have a subsequent DRF fracture compared to the NM group. There was
no difference between groups in combined intertrochanteric and femoral neck
fractures. Vertebral compression fractures demonstrated a small but statistically
significant increase in the M group, with an absolute risk difference of 0.8%
(number needed to treat = 125) and an effect size (Cohen's h = 0.079), suggesting
limited clinical relevance. CONCLUSIONS: Timely assessment and medical
intervention can prevent future DRF. However, post-DRF bone density evaluations
remain infrequent. This study highlights the hand surgeon's role in identifying
osteoporosis. Level of Evidence: Level III Cohort Study.