Daruwalla Z J, Huq S S, Wong K L, Nee P Y, Leong K M, Pillay K R, Murphy D P
Department of Orthopaedic Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
National University of Singapore, Singapore, Singapore.
Osteoporos Int. 2016 Jan;27(1):361-6. doi: 10.1007/s00198-015-3375-8. Epub 2015 Oct 28.
Both men and women who sustain a fracture of the distal forearm run an increased risk of sustaining a subsequent hip fracture. Our study implies that these patients may not necessarily constitute a group in which osteoporosis screening is warranted.
People who sustain a distal radius fracture run an increased risk of sustaining a subsequent hip fracture. However, many institutions only screen for osteoporosis at the time of a hip fracture. We aimed to determine the true incidence of preceding distal radius fractures in an Asian population of patients with a hip fracture aged 60 years or older and whether screening for osteoporosis earlier would be beneficial.
We reviewed 22 parameters of 572 patients aged 60 years or older admitted after sustaining a hip fracture over a 3-year period. This included the occurrence or absence of a distal radius fracture in the 10 years preceding their hip fracture.
Twenty-nine patients (5 %) had a fracture of the distal radius in the preceding decade. Univariate analyses suggested that hip fracture patients who had preceding distal radius fractures were older, female, have lower mean haemoglobin levels, and right-sided hip fractures. Of these factors, only age was found to have significant predictive value in a multivariate analysis.
A number of institutions have started to screen for osteoporosis when a patient presents with a fracture of the distal radius because these patients may have an increased risk of a subsequent hip fracture. Our study implies that this may not be warranted. Implementing such a screening service from both cost and resource utilization point of view must be studied prospectively and in greater detail considering earlier screening may only be beneficial to a very small percentage of patients.
前臂远端骨折的男性和女性发生后续髋部骨折的风险都会增加。我们的研究表明，这些患者不一定构成一个有必要进行骨质疏松症筛查的群体。
桡骨远端骨折的患者发生后续髋部骨折的风险会增加。然而，许多机构仅在髋部骨折时才进行骨质疏松症筛查。我们旨在确定60岁及以上髋部骨折的亚洲患者群体中既往桡骨远端骨折的真实发生率，以及更早进行骨质疏松症筛查是否有益。
我们回顾了572例60岁及以上在3年期间因髋部骨折入院患者的22项参数。这包括他们髋部骨折前10年是否发生过桡骨远端骨折。
29例患者（5%）在之前十年中有桡骨远端骨折。单因素分析表明，既往有桡骨远端骨折的髋部骨折患者年龄更大、为女性、平均血红蛋白水平更低，且为右侧髋部骨折。在这些因素中，多因素分析仅发现年龄具有显著预测价值。
一些机构在患者出现桡骨远端骨折时已开始进行骨质疏松症筛查，因为这些患者后续发生髋部骨折的风险可能增加。我们的研究表明这可能没有必要。从成本和资源利用的角度来看，实施这样的筛查服务必须进行前瞻性且更详细的研究，因为更早的筛查可能仅对极少数患者有益。
