UNLABELLED:
One third of 218 men and half of 1,576 women with low-energy distal radius fractures met the bone mineral density (BMD) criteria for osteoporosis treatment. A large proportion of patients with increased fracture risk did not have osteoporosis. Thus, all distal radius fracture patients >or=50 years should be referred to bone densitometry.

INTRODUCTION:
Main objectives were to determine the prevalence of patients with a low-energy distal radius fracture in need of osteoporosis treatment according to existing guidelines using T-score < or= -2.0 or < or=-2.5 standard deviation (SD) and calculate their fracture risk.

METHODS:
A total of 218 men and 1,576 women >or=50 years were included. BMD was assessed by dual energy X-ray absorptiometry (DXA) at femoral neck, total hip, and lumbar spine (L2-L4). The WHO fracture risk assessment tool (FRAX(R)) was applied to calculate the 10-year fracture risk.

RESULTS:
T-scores < or=-2.0 and < or=-2.5 SD at femoral neck was found in 37.7% and 19.6% of men and 51.1% and 31.2% of women, respectively. The risk of hip fracture was 6.2% for men and 9.0% for women. The corresponding figures for patients with T-score < or=-2.0 SD were 11.6% and 14.5% and for T-score < or=-2.5 SD 16.3% and 18.2%, respectively. A large proportion of distal radius fracture patients with a high 10-year FRAX risk did not have osteoporosis.

CONCLUSIONS:
Every second to every third fracture patient met the present BMD criteria for osteoporosis treatment. Because a large proportion of distal radius fracture patients did not have osteoporosis, treatment decisions should not be based on fracture risk assessment without bone densitometry. Thus, all distal radius fracture patients >or=50 years should be referred to bone densitometry, and if indicated, offered medical treatment.





Polls results
1

On a scale of 1 to 10, rate how much this article will change your clinical practice?

NO change
BIG change
80% Article relates to my practice (8/10)
20% Article does not relate to my practice (2/10)
0% Undecided (0/10)
2

Will this article lead to more cost-effective healthcare?

70% Yes (7/10)
10% No (1/10)
20% Undecided (2/10)
3

Was this article biased? (commercial or personal)

0% Yes (0/10)
90% No (9/10)
10% Undecided (1/10)
4

What level of evidence do you think this article is?

0% Level 1 (0/10)
20% Level 2 (2/10)
60% Level 3 (6/10)
20% Level 4 (2/10)
0% Level 5 (0/10)