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Osteoporosis as a Risk Factor for Distal Radial FracturesA Case-Control Study
Jannike Øyen, MSc1; Christina Brudvik, PhD, MD1; Clara Gram Gjesdal, PhD, MD2; Grethe S. Tell, PhD, MPH3; Stein Atle Lie, PhD, MSc1; Leiv M. Hove, PhD, MD1
1 Department of Surgical Sciences, University of Bergen, N-5021 Bergen, Norway. E-mail address for J. Øyen: jannike.oyen@kir.uib.no. E-mail address for C. Brudvik: Christina.brudvik@kir.uib.no. E-mail address for S.A. Lie: stein.lie@smis.uib.no. E-mail address for L.M. Hove: leiv.hove@kir.uib.no
2 Department of Rheumatology, Haukeland University Hospital, N-5021 Bergen, Norway. E-mail address: clara.gjesdal@helse-bergen.no
3 Department of Public Health and Primary Health Care, University of Bergen, N-5018 Bergen, Norway. E-mail address: grethe.tell@isf.uib.no
View Disclosures and Other Information
Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from The Research Council of Norway, the University of Bergen, and The Western Norway Health Authority. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at the Departments of Orthopedic Surgery and Rheumatology, Haukeland University Hospital, Bergen, and the Bergen Accident and Emergency Department, Bergen, Norway

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Feb 16;93(4):348-356. doi: 10.2106/JBJS.J.00303
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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.


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.


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.


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.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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