Department of Orthopedic Surgery, Eulji University College of Medicine, 1306 Dunsan-dong, Seo-gu, Daejeon, 35233, South Korea.
BMC Musculoskelet Disord. 2023 Mar 9;24(1):177. doi: 10.1186/s12891-023-06265-5.
Recent studies have demonstrated that the distal forearm dual-energy X-ray absorptiometry (DEXA) scan might be a better method for screening bone mineral density (BMD) and the risk of a distal forearm fracture, compared with a central DEXA scan. Therefore, the purpose of this study was to determine the effectiveness of a distal forearm DEXA scan for predicting the occurrence of a distal radius fracture (DRF) in elderly females who were not initially diagnosed with osteoporosis after a central DEXA scan.
Among the female patients who visited our institutes and who were over 50 years old and underwent DEXA scans at 3 sites (lumbar spine, proximal femur, and distal forearm), 228 patients with DRF (group 1) and 228 propensity score-matched patients without fractures (group 2) were included in this study. The patients' general characteristics, BMD, and T-scores were compared. The odds ratios (OR) of each measurement and correlation ratio among BMD values of the different sites were evaluated.
The distal forearm T-score of the elderly females with DRF (group 1) was significantly lower than that of the control group (group 2) (p < 0.001 for the one-third radius and ultradistal radius measurements). BMD measured during the distal forearm DEXA scan was a better predictor of DRF risk than BMD measured during the central DEXA (OR = 2.33; p = 0.031 for the one-third radius, and OR = 3.98; p < 0.001 for the ultradistal radius). The distal one-third radius BMD was correlated with hip BMD, rather than lumbar BMD (p < 0.05 in each group).
Performing a distal forearm DEXA scan in addition to a central DEXA scan appears to be clinically significant for detecting the low BMD in the distal radius, which is associated with osteoporotic DRF in elderly females.
III; case-control study.
最近的研究表明，与中央双能 X 射线吸收法（DEXA）扫描相比，远端前臂 DEXA 扫描可能是一种更好的筛查骨密度（BMD）和远端前臂骨折风险的方法。因此，本研究的目的是确定远端前臂 DEXA 扫描在中央 DEXA 扫描后未被诊断为骨质疏松症的老年女性中预测桡骨远端骨折（DRF）发生的有效性。
在我院就诊且年龄在 50 岁以上并在 3 个部位（腰椎、股骨近端和远端前臂）进行 DEXA 扫描的女性患者中，纳入了 228 例桡骨远端骨折患者（第 1 组）和 228 例骨折匹配患者（第 2 组）。比较了患者的一般特征、BMD 和 T 评分。评估了各测量值的比值比（OR）和不同部位 BMD 值之间的相关比。
桡骨远端骨折的老年女性（第 1 组）的远端前臂 T 评分明显低于对照组（第 2 组）（三分之一桡骨和远段桡骨测量，p < 0.001）。远端前臂 DEXA 扫描测量的 BMD 是桡骨远端骨折风险的更好预测指标，优于中央 DEXA 扫描（三分之一桡骨 OR = 2.33；p = 0.031，远段桡骨 OR = 3.98；p < 0.001）。远段三分之一桡骨 BMD 与髋部 BMD 相关，而与腰椎 BMD 不相关（每组均为 p < 0.05）。
在中央 DEXA 扫描的基础上增加远端前臂 DEXA 扫描，对于检测与老年女性骨质疏松性 DRF 相关的远端桡骨低 BMD 具有临床意义。
III；病例对照研究。
