Women with wrist fractures often receive less osteoporosis care than those with hip or spine fractures

Korean women older than 50 years who suffered a wrist fracture were managed and evaluated for osteoporosis less aggressively than their counterparts with spine or hip fractures, according to a retrospective study.

Physicians who treat these wrist fractures in women should initiate an osteoporosis workup or refer them to a specialist for evaluation, according to Hyun S. Gong, MD, and colleagues in the department of orthopedic surgery at Seoul National University Bundang Hospital in Seongnam, South Korea.

In their 2007 study, Gong and colleagues said additional research could help eliminate these treatment disparities.

Investigators retrospectively reviewed the fracture incidence in 97% of all Korean women older than 50 years, analyzing how fracture location correlated to trends observed in prescribing bone mineral density (BMD) scans and osteoporosis medication.

“Our review of this national cohort indicates that patients with a wrist fracture are less likely to be evaluated and managed for osteoporosis than those with a hip or spine fracture by physicians who are responsible for treating symptomatic fractures,” Gong wrote in the abstract of his study, which was published in the October issue of the Journal of Bone and Joint Surgery.

“Our hypothesis was that physicians who treat fractures of the hip, spine and wrist have different propensities or practice patterns regarding the evaluation and treatment of osteoporosis,” Gong stated in a press release from the American Academy of Orthopaedic Surgeons.

Because women who sustain a wrist fracture generally do so when they are younger, there is a greater opportunity for clinicians to initiate secondary intervention in this population, according to the investigators.

“We find it disappointing that many orthopedic and hand surgeons who treat wrist fractures choose not to provide osteoporosis evaluation and treatment, when in our opinion, they should do so,” Gong said.

Many patients and some physicians believe that a wrist fracture is less serious than other types of fractures — a mindset that may contribute to a reluctance to undergo a BMD examination or use osteoporosis therapies, Gong noted.

Reference:
Gong HS, Oh WS, Chung MS, et al. Patients with wrist fractures are less likely to be evaluated and managed for osteoporosis. J Bone Joint Surg (Am). 2009;91:2376-2380.