Changes in hand bone density after distal radius fracture and correlation with clinical parameters: A longitudinal study

Abstract

Study Design: Prospective, case-control study Background: Post-fracture loss of bone density has been a well known phenomenon. However, there was a paucity in the literature about changes in hand bone densitometry in patients having distal radius fracture. And also, it’s unclear whether there is a relationship between disease parameters. Objective: To measure hand bone mineral density (BMD) by dual x-ray absorptiometry and to investigate clinical correlates in patients with DRF in a prospective, longitudinal study. Material and Methods: Forty-nine patients with DRF (21 women, (range 30 to 43 years), 28 men (range 30 to 56 years)) were included in the study. Patients were divided into 2 groups according to having diagnosed of CRPS: Group I: Patients with CRPS (DRF/CRPS), Group II: Patients without CRPS (DRF/non-CRPS). All tests were undertaken at the 1st visit at the time when the patient came to our clinic and at the 2nd visit (52nd week). Results: The group-analysis showed that in group I (DRF/CRPS) hand BMD of fractured side (t score: -2.5) was found to be statistically lower than those of group II (DRF/non-CRPS) (t score: -1.2) at the 2nd visit (p<0.05). Within the group analysis, a statistically significant decrease in fractured hand BMD has been found during one year, only in Group I (p<0.05) (t score from -1.3 to -2.5). Correlation analysis showed that the clinical parameters at the 1st visit were significantly negatively correlated with the hand BMD of the 2nd visit only in group I (DRF/CRPS) (SHSS: R=-0.209, p=0.008, DASH: R=-0.120, p=0.01, VAS: R=-0.149, p=0.031). There was no correlation between hand BMD and other clinical and demographical indices (p>0.05). Conclusion: These results showed that there was a significant reduction of hand BMD in patients with distal radius fracture with CRPS during one year. The reduction in BMD correlated with the severity of CRPS, pain, and upper extremity dysfunction. © 2020 Elsevier B.V., All rights reserved.