Is Distal Forearm Fracture in Men due to Osteoporosis? |
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Authors: | S P Tuck N Raj G D Summers |
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Institution: | (1) Derbyshire Royal Infirmary, Derby;, GB;(2) Osteoporosis Clinic, Derby City General Hospital, Derby, UK, GB |
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Abstract: | Although widely regarded as a disease of women, osteoporosis does cause considerable morbidity and mortality in men. The
lifetime risk of an osteoporortic fracture for a man is 1 in 12 and 30% of all hip fractures occur in men. In women, low-trauma
distal forearm fracture is widely regarded as a typical early manifestation of postmenopausal osteoporosis. Traditionally,
this has not been thought to be the case for men. We present a case–control study of 147 men with distal forearm fracture
compared with 198 age-matched controls. The controls were selected from a pre-existing database of dual-energy X-ray absorptiometry
scans of healthy volunteers. Both groups were sent questionnaires regarding basic demographics, fracture history and risk
factors for osteoporosis, and the fracture group was asked to attend for bone densitometry. There were 103 responses from
the fracture group (70%), of whom 67 (47%) underwent densitometry. There were 165 (83%) responses from the control group.
Secondary causes of osteoporosis could be identified in 51% of the fracture group and 37% of the control group. The fracture
group had significantly lower bone mineral density at all sites measured compared with the controls (0.75 g/cm2 vs 0.85 g/cm2 at the femoral neck, p<0.0001; 0.95 g/cm2 vs 1.03 g/cm2 at the total femur, p= 0.001; and 0.99 g/cm2 vs 1.06 g/cm2 at the lumbar spine, p= 0.001). These differences remained after adjusting for age and body mass index (p<0.0005 at all sites). Overall, 41.8% of the fracture group were osteoporotic in at least one site (T-score <−2.5 SD below the mean for young men) compared with only 10.3% of controls. This study is the first to demonstrate
that men with distal forearm fractures have lower bone mineral density than their peers and a higher risk of osteoporosis.
Received: 28 November 2001 / Accepted: 19 February 2002 |
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Keywords: | :Forearm fractures – Male – Osteoporosis |
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