Kong Matthew Tsz Kin, Fang Christian, Yung Colin Shing Yat, Kwok Theresa, Leung Keith, Leung Frankie
Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Rd, Pok Fu Lam, Hong Kong, China.
Department of Orthopaedics and Traumatology, Queen Mary Hospital The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
Arch Osteoporos. 2025 Jan 16;20(1):10. doi: 10.1007/s11657-024-01465-5.
Grip strength measurement, as a surrogate of sarcopenia diagnosis, effectively predicts secondary fracture risk in distal radius fracture patients. This simple tool enhances clinical practice by identifying high-risk patients for targeted interventions, potentially preventing or reversing functional decline and recurrent fractures.
To evaluate grip strength and hand muscle cross-sectional area as predictors of secondary fracture risk in patients with a history of distal radius fracture (DRF), serving as surrogates of the diagnosis of sarcopenia.
A retrospective cohort study of 745 DRF patients was analyzed with their grip strength data using Cox proportional hazards regression, receiver operating characteristic analysis, and Kaplan-Meier analysis to predict secondary fracture risk over an average of 12 years. Hand muscle cross-sectional area was similarly analyzed.
Patients with a history of DRF were predicted to have a 4.1% higher likelihood of experiencing a secondary fracture per kilogram reduction in their grip strength (p < 0.008), independent of age and sex. Patients were categorized as high-risk (≤ 16 kg), moderate-risk (17-24 kg), or low-risk (≥ 25 kg) (p < 0.001). High-risk patients showed a 2.2-fold (95% CI = 1.55-3.17) higher recurrent fracture risk compared to low-risk patients. Cumulative secondary fracture probabilities of the high-risk group patients at 5, 10, and 15 years were estimated to be 16%, 30%, and 54%, respectively.
Grip strength measurement, as a surrogate of sarcopenia diagnosis, effectively predicts secondary fracture risk in patients with DRF. This simple tool could improve clinical practice by identifying high-risk patients for targeted interventions to prevent recurrent fractures or even reverse functional decline.
握力测量作为肌肉减少症诊断的替代指标，可有效预测桡骨远端骨折患者的二次骨折风险。这个简单的工具通过识别高危患者进行有针对性的干预，从而改善临床实践，有可能预防或逆转功能衰退和复发性骨折。
评估握力和手部肌肉横截面积作为桡骨远端骨折（DRF）病史患者二次骨折风险的预测指标，作为肌肉减少症诊断的替代指标。
对745例DRF患者进行回顾性队列研究，使用Cox比例风险回归、受试者工作特征分析和Kaplan-Meier分析对其握力数据进行分析，以预测平均12年的二次骨折风险。对手部肌肉横截面积进行类似分析。
有DRF病史的患者，其握力每降低1千克，发生二次骨折的可能性预计会增加4.1%（p < 0.008），与年龄和性别无关。患者被分为高危（≤16千克）、中危（17 - 24千克）或低危（≥25千克）（p < 0.001）。与低危患者相比，高危患者的复发性骨折风险高2.2倍（95% CI = 1.55 - 3.17）。高危组患者在5年、10年和15年时的累积二次骨折概率估计分别为16%、30%和54%。
握力测量作为肌肉减少症诊断的替代指标，可有效预测DRF患者的二次骨折风险。这个简单的工具可以通过识别高危患者进行有针对性的干预来预防复发性骨折甚至逆转功能衰退，从而改善临床实践。
