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Osteoporosis evaluation rates after distal radial fractures 'unacceptable' in older men
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Fewer men than women were evaluated for osteoporosis after a distal radial fracture, with evaluation rates unacceptably low based on published guidelines, according to findings in The Journal of Bone & Joint Surgery.
“One out of four men will sustain a fracture in their lifetime, and one fracture greatly increases your risk of a second fragility fracture,” Tamara D. Rozental, MD, of Harvard Medical School and Beth Israel Deaconess Medical Center, told Endocrine Today.
Tamara D. Rozental
Rozental, along with Carl M. Harper, MD, and colleagues retrospectively reviewed medical records for 439 patients (344 women, 95 men) older than 50 years treated for a distal radial fracture at a single institution during 5 years to determine patterns of injury and evaluation rates.
The researchers assessed whether patients had received a DXA scan and osteoporosis treatment in the 6 months after their injury. Multivariate analysis was used to identify independent predictors for bone mineral density testing and osteoporosis treatment.
Fractures seen in men were less severe than in women, with rates of those involving the wrist joint at 20% for men and 40% in women (P=.014). After injury, 184 (53%) women had a DXA scan, but only 17 (18%) men were evaluated (P<.001). Among patients who had DXA, nine (9%) men and 65 (19%) women were diagnosed with osteoporosis (P=.01).
The proportion of women (55%; 95% CI, 48-62) started on calcium and vitamin D supplements was more than double that of men (21%; 95% CI, 11-30). Further, 3% of men vs. 22% of women were started on bisphosphonates (P<.001).
Male sex was an independent predictor for not having a BMD test and not receiving subsequent treatment with calcium and vitamin D or bisphosphonates (P<.001).
“We need to better characterize men with fractures in terms of their bone health; we don’t yet know how many men with fractures have osteoporosis,” Rozental said. “We also need to determine whether men should be treated in similar fashion to women or whether treatment guidelines should be different for them.” – by Allegra Tiver
For more information:
Tamara D. Rozental, MD, can be reached at Harvard Medical School, Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Stoneman 10, Boston, MA 02215; email: trozenta@bidmc.harvard.edu.
Disclosure: The researchers report no relevant financial disclosures.
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