Michael Yam, Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore. Annex 1 level 2, 11 Jalan Tan Tock Seng, Novena, Singapore 308433. Phone: +6563577705 Email:
J Frailty Aging. 2022;11(2):169-176. doi: 10.14283/jfa.2022.6.
Sarcopenia is an emerging disease that adversely impacts outcomes of older adults across the spectrum of fragility fractures. Few studies have examined sarcopenia in upstream fragility fractures such as the distal radius. Understanding the state of current evidence is essential in defining a research agenda in this critical area of sentinel distal radius fractures and sarcopenia.
The aim of this scoping review was to summarize existing literature on sarcopenia in distal radius fracture in older adults, and to identify research areas and gaps to guide future studies.
We utilized the 5-stage framework of Arksey and O'Malley. We searched studies from 2010 to 2020 relating to «Sarcopenia» and «Distal radius fractures» in major databases. Two reviewers independently screened articles for inclusion and conducted full text reviews of shortlisted articles. We extracted data on research areas, key findings, and study limitations.
Thirteen studies met the inclusion and exclusion criteria. They covered the areas of epidemiology (N=9), risk factors (N=4), basic science (N=2), outcomes (N=1), and diagnostic modalities (N=1). There were no studies on screening/case finding, prognostic scoring, intervention, or health economics. Identified limitations included the lack of clear definition and diagnostic criteria for sarcopenia, and lack of, or inappropriate, control group. Majority of studies were retrospective or cross-sectional in study design.
This scoping review on sarcopenia in distal radius fractures highlighted gaps in research areas and in the rigor of studies conducted, and the need for more prospective cohort and interventional studies. Building upon current consensus criteria, we propose setting a research agenda along the timeline of sarcopenia management, from screening through to intervention and follow-up, which will inform future research in this early disease cohort of fragility fractures.
肌少症是一种新兴疾病,会对各年龄段脆性骨折患者的预后产生不利影响。很少有研究关注桡骨远端等上游脆性骨折中的肌少症。了解当前证据的状况对于确定在这个关键的哨兵桡骨远端骨折和肌少症领域的研究议程至关重要。
本范围综述旨在总结老年人桡骨远端骨折中肌少症的现有文献,并确定研究领域和差距,以指导未来的研究。
我们采用了 Arksey 和 O'Malley 的 5 阶段框架。我们在主要数据库中搜索了 2010 年至 2020 年与“肌少症”和“桡骨远端骨折”相关的研究。两名评审员独立筛选文章以确定纳入标准,并对入选文章进行全文审查。我们提取了研究领域、主要发现和研究局限性的数据。
符合纳入和排除标准的研究共有 13 项。它们涵盖了流行病学(N=9)、危险因素(N=4)、基础科学(N=2)、结果(N=1)和诊断方法(N=1)等领域。没有关于筛查/病例发现、预后评分、干预或健康经济学的研究。已确定的局限性包括肌少症缺乏明确的定义和诊断标准,以及缺乏或不适当的对照组。大多数研究在研究设计上都是回顾性或横断面的。
这项关于桡骨远端骨折中肌少症的范围综述强调了研究领域和研究严谨性方面的差距,以及需要更多的前瞻性队列和干预研究。在当前共识标准的基础上,我们建议按照肌少症管理的时间线制定研究议程,从筛查到干预和随访,这将为这一早期脆性骨折疾病队列的未来研究提供信息。