Are metatarsal fractures indicative of osteoporosis in postmenopausal women?

Patients who sustain low trauma fractures are at a higher risk of osteoporosis. However, there are conflicting data concerning whether metatarsal fractures are also associated with low bone mineral density. The authors retrospectively analyzed data on 68 postmenopausal women who had sustained a low trauma metatarsal fracture. Routine assessment of these patients included identification of risk factors for fracture, height and weight measurement, and measurement of peripheral bone density at the heel by dual-energy X-ray absorptiometry (Calscan, Demetech AB, Täby, Sweden). Bone density in the patients was compared with manufacturer's reference database. The mean Z-score for the patients was -0.08. In total, 14 women (20.5% [confidence interval 10.5 to 29.5]) had a Z-score ≤-1, and 1 patient (1.5% [confidence interval -1.4 to 4.4]) had a Z-score ≤-2. Mean T-score in these women was -1.95. Since the number of women with a Z-score ≤-1 was not significantly greater than the 16% that would be expected, and the number of women with a Z-score ≤-2 was not significantly greater than the 2.5% expected, it is concluded that low trauma metatarsal fracture is not a risk factor for low calcaneal bone mineral density.