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Osteoporosis as a Risk Factor for Distal Radial Fractures: A Case-Control Study

Øyen, Jannike MSc; Brudvik, Christina PhD, MD; Gjesdal, Clara Gram PhD, MD; Tell, Grethe S. PhD, MPH; Lie, Stein Atle PhD, MSc; Hove, Leiv M. PhD, MD

Journal of Bone & Joint Surgery - American Volume: 16 February 2011 - Volume 93 - Issue 4 - p 348–356
doi: 10.2106/JBJS.J.00303
Scientific Articles

Background: Distal radial fractures occur earlier in life than hip and spinal fractures and may be the first sign of osteoporosis. The aims of this case-control study were to compare the prevalence of osteopenia and osteoporosis between female and male patients with low-energy distal radial fractures and matched controls and to investigate whether observed differences in bone mineral density between patients and controls could be explained by potential confounders.

Methods: Six hundred and sixty-four female and eighty-five male patients who sustained a distal radial fracture, and 554 female and fifty-four male controls, were included in the study. All distal radial fractures were radiographically confirmed. Bone mineral density was assessed with use of dual x-ray absorptiometry at the femoral neck, total hip (femoral neck, trochanter, and intertrochanteric area), and lumbar spine (L2-L4). A self-administered questionnaire provided information on health and lifestyle factors.

Results: The prevalence of osteoporosis was 34% in female patients and 10% in female controls. The corresponding values were 17% in male patients and 13% in male controls. In the age group of fifty to fifty-nine years, 18% of female patients and 5% of female controls had osteoporosis. In the age group of sixty to sixty-nine years, the corresponding values were 25% and 7%, respectively. In adjusted conditional logistic regression analyses, osteopenia and osteoporosis were significantly associated with distal radial fractures in women. Osteoporosis was significantly associated with distal radial fractures in men.

Conclusions: The prevalence of osteoporosis in patients with distal radial fractures is high compared with that in control subjects, and osteoporosis is a risk factor for distal radial fractures in both women and men. Thus, patients of both sexes with an age of fifty years or older who have a distal radial fracture should be evaluated with bone densitometry for the possible treatment of osteoporosis.

Level of Evidence: Prognostic Level III. See Instructions to Authors for a complete description of levels of evidence.

1Department of Surgical Sciences, University of Bergen, N-5021 Bergen, Norway. E-mail address for J. Øyen: E-mail address for C. Brudvik: E-mail address for S.A. Lie: E-mail address for L.M. Hove:

2Department of Rheumatology, Haukeland University Hospital, N-5021 Bergen, Norway. E-mail address:

3Department of Public Health and Primary Health Care, University of Bergen, N-5018 Bergen, Norway. E-mail address:

Copyright 2011 by The Journal of Bone and Joint Surgery, Incorporated
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