The Effect of Bone Mineral Density on Functional and Radiological Outcomes of Conservatively Treated Distal Radius Fractures

INTRODUCTION: Distal radius fractures are among the most common fractures seen in clinical practice. These fractures usually occur due to trauma, and their management varies from conservative treatment with closed reduction and immobilization to surgical intervention. Several factors affect the outcome of distal radius fractures, including age, gender, fracture type, and bone quality. Bone mineral density (BMD) is a measure of bone quality and has been shown to affect the healing of fractures in various bones, including the distal radius. The purpose of this study was to evaluate the effect of BMD on the functional and radiological outcomes of conservatively treated distal radius fractures.
METHODS: This study was approved by the Adana City Hospital Ethics Committee, and written consent was obtained from all patients. A total of 56 patients (22 men and 34 women, mean age 59.2 (50-79)) with distal radius fractures were included in the study. Patients with additional complications, additional pathology, multi-trauma, and open fractures were excluded. Demographic information, including gender, age, and chronic diseases, was collected. Fractures were classified according to the Frykman and AO systems. BMD measurements were performed using dual-energy x-ray absorptiometry. Radial inclination and volar tilt values were measured on posteroanterior and lateral plane wrist radiographs. Casts were removed when a solid union was observed, and a home rehabilitation program was initiated. Gartland-Werley functional scoring was used for clinical evaluation.
RESULTS: There was no significant difference between the two groups in terms of fracture type, dominant side, gender distribution, and mean age. There was also no significant difference between the groups in terms of radial slope loss, volar tilt loss, or amount of radial shortening. Furthermore, there was no significant difference between the groups in terms of union time. However, functional scores were significantly lower in the low BMD group, and a significant positive correlation was found between BMD and functional outcomes. There was no significant correlation between functional scores and radial shortening amount, radial inclination, or volar tilt loss.
DISCUSSION AND CONCLUSION: This study suggests that low BMD values do not have a significant effect on the time of union and reduction loss in conservatively treated distal radius fractures but negatively affect the functional results. Therefore, BMD measurement may be considered in the management of distal radius fractures, especially in older patients or those with osteoporosis. However, further studies with larger sample sizes are needed to confirm these findings.