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This article discusses the importance of early osteoporosis intervention in patients with distal radius fractures (DRFs), which are the most common first-ever osteoporotic fragility fractures. The study enrolled 30 patients aged 50 years or older who underwent surgical treatment for DRFs and had no history of fragility fractures or osteoporosis treatment. Patients with low bone mineral density values were treated with zoledronic acid. The study found that the treatment significantly improved bone mineral density values and biomarkers of bone turnover. Adverse drug reactions were observed in 40% of patients, but age, body mass index, and creatinine clearance did not significantly affect the occurrence of adverse effects. The study also found that bone fusion occurred at a mean of 3.6 months postoperatively and secondary fractures were observed in 3 patients within 60 months after treatment. The authors conclude that aggressive osteoporosis treatment is important to prevent secondary fractures in patients with DRFs
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised day surgery spinal centre in London
Published article
CONCLUSION: DRFs occur at a younger age than other fragility fractures, and it is important to intervene aggressively with osteoporosis treatment to prevent secondary fractures.
Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
J Orthop. 2023 Jul 28;43:109-114. doi: 10.1016/j.jor.2023.07.019. eCollection 2023 Sep.ABSTRACTBACKGROUND: Distal radius fractures (DRFs) are the most frequent first-ever osteoporotic fragility fractures. However, most patients are treated only for fractures and not for osteoporosis. Therefore, we investigated early osteoporosis intervention using zoledronic acid.METHODS: This prospective study enrolled 30 patients aged 50 years or older who,
J Orthop. 2023 Jul 28;43:109-114. doi: 10.1016/j.jor.2023.07.019. eCollection 2023 Sep.
ABSTRACT
BACKGROUND: Distal radius fractures (DRFs) are the most frequent first-ever osteoporotic fragility fractures. However, most patients are treated only for fractures and not for osteoporosis. Therefore, we investigated early osteoporosis intervention using zoledronic acid.
METHODS: This prospective study enrolled 30 patients aged 50 years or older who had no history of fragility fractures or osteoporosis treatment and who underwent surgical treatment for DRFs. Patients whose lumbar spine or femur bone mineral density (BMD) values were less than 80% of the young adult mean (YAM) were treated with a 5-mg intravenous infusion of zoledronic acid. Lumbar spine and femur YAM BMD values, TRACP-5b and PINP were statistically evaluated using the paired t-test. The relationship between adverse effects, age, body mass index (BMI), and creatinine clearance (CCr) was statistically examined using Mann-Whitney’s U test. The incidence of the bone fusion and secondary fractures within the 60-months postoperative period were assessed.
RESULTS: The mean lumbar spine and femur YAM BMD values before treatment were 76.1 ± 13.1% and 70.7 ± 8.5%. This indicates osteopenia in both locations. These values differed significantly between the pre-treatment period and each subsequent period. Five patients with a target YAM BMD value over 80% within 60 months after treatment were observed. The TRACP-5b and PINP values differed significantly between the pre-treatment period and each subsequent period. Adverse drug reactions were observed in 12 patients (40%). Age, BMI, and CCr did not show statistically significant differences in the occurrence of adverse effects. Bone fusion was confirmed at a mean of 3.6 months postoperatively. Secondary fractures were observed in 3 patients within 60 months after treatment.
CONCLUSION: DRFs occur at a younger age than other fragility fractures, and it is important to intervene aggressively with osteoporosis treatment to prevent secondary fractures.
LEVEL OF EVIDENCE: Level V.
PMID:37559884 | PMC:PMC10407814 | DOI:10.1016/j.jor.2023.07.019
The London Spine Unit : best recognised day surgery spinal centre in London
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Zoledronic acid for osteoporosis after distal radius fracture surgery
