Real-world evaluation and management of osteoporosis in postmenopausal women following distal radius fracture.

INTRODUCTION

This study aimed to evaluate the factors associated with the initiation and maintenance of osteoporosis evaluation and management in postmenopausal women following distal radius fracture (DRF).

MATERIALS AND

METHODS

We retrospectively reviewed 341 consecutive postmenopausal women who sustained a DRF after minor trauma between January 2018 and August 2021. Data on baseline characteristics, general medical condition (assessed using the American Society of Anesthesiologists classification system), dual-energy X-ray absorptiometry (DXA) results, and osteoporosis treatments before and up to two years following DRF were collected.

RESULTS

After excluding 36 patients who were receiving anti-osteoporosis medication at the time of DRF, 305 patients were recommended for DXA evaluation after DRF. Sixteen patients (5.2%) with normal DXA results were not prescribed medication. Fifty patients (16.4%) either declined DXA evaluation or refused to initiate anti-osteoporosis medications (refusal group), while 239 patients initiated anti-osteoporosis medication (initiation group). A significantly higher portion of patients in the initiation group underwent surgery for DRF compared with the refusal group (82.0% vs. 68.0%, p = 0.03). Among the 239 patients who initiated anti-osteoporosis treatment, 164 (68.6%) maintained medication for two years. In multivariable analysis, only a diagnosis of osteoporosis rather than osteopenia was significantly associated with medication maintenance (odds ratio 1.960; 95% confidence interval, 1.117-3.440, p = 0.02).

CONCLUSIONS

This study found that postmenopausal women who received non-operative treatment or had osteopenia on DXA are less likely to initiate or maintain osteoporosis evaluation and management following DRF. Clinicians need to emphasize osteoporosis evaluation and treatment adherence, particularly in these patients following DRF.