Perimenopausal wrist fracture - An opportunity for prevention and management of osteoporosis

Abstract

Objective: Review of Medscheme's administrative databases to study the relationship between hip fracture and previous wrist fracture in peri- and postmenopausal women. Design: Retrospective analysis of 1995 - 1998 data for women aged 50 and above hospitalised for management of wrist fracture. Those identified were subjected to further review to establish rates of osteoporosis and/or hip fracture. Osteoporosis and/or hip fracture rates were also determined for a control population. Main outcome measures: Osteoporosis investigation and management rates in controls v, subjects who had experienced a previous wrist fracture. Results: A total of 701 subjects was admitted to hospital for management of a wrist fracture between 1995 and 1998, and compared with 1 385 similarly aged controls. Diagnosis of osteoporosis and admission for hip fracture were more common in women who had experienced a previous 'wrist fracture (relative risk (RR) 1.55; 95% confidence interval (Cl) 1.19 - 2.03 for osteoporosis, and RR 3.32; 95% 0 1.16 - 9.69 for hip fracture). Of 10 hip fractures which occurred in the wrist fracture group, 9 were in women not diagnosed as having, or treated for, osteoporosis. Conclusion: While women with a history of wrist fracture are more likely than controls to be tested and treated for osteoporosis, it nevertheless appears that insufficient attention is being paid to this premonitory event.

S Afr Med J 2000; 90: 1121-1124