The Effect of Osteoporosis on the Outcomes After Volar Locking Plate Fixation in Female Patients Older than 50 Years With Unstable Distal Radius Fractures

J Hand Surg Am. 2018 Aug;43(8):731-737. doi: 10.1016/j.jhsa.2018.05.028. Epub 2018 Jul 2.


Purpose: The aim of this study was to investigate the effect of osteoporosis on radiological and clinical outcomes after volar locking plate (VLP) fixation in women older than 50 years with unstable distal radius fractures (DRFs).

Methods: We retrospectively reviewed data of 79 women older than 50 years with DRFs treated by VLP fixation. We collected patients' baseline data, including age and bone mineral density. We also measured the cortical thickness of the distal radius on plain radiographs and computed tomography to assess local bone density. Radiological outcomes included late displacement at 1 year after surgery, which was defined as a change in radiological parameters (radial inclination, volar tilt, and ulnar variance). Clinical outcomes were assessed with the Disabilities of the Arm, Shoulder, and Hand (DASH) and modified Mayo wrist score at 1 year after surgery. We compared mean values between the nonosteoporotic (group 1, T score > -2.5) and the osteoporotic groups (group 2, T score ≤ -2.5). We conducted linear and logistic regression analysis to investigate factors associated with poor outcomes.

Results: There were 49 patients in group 1 and 30 patients in group 2. Radiological outcomes were similar in both groups. The mean DASH score was 14.9 (SD, 16.4) for group 1 and 12.5 (SD, 13.5) for group 2, and the mean modified Mayo wrist score was 87.6 (SD, 8.8) for group 1 and 88.2 (SD, 11.4) for group 2. There were no significant differences in clinical outcomes between groups. Simple and multivariable linear regression analysis showed only older age was associated with the change in volar tilt. Osteoporosis and cortical thickness were not associated with poor clinical outcomes on simple logistic regression analysis.

Conclusions: Osteoporosis and cortical thickness of the distal radius did not affect clinical outcomes after VLP fixation in women older than 50 years with unstable DRFs.

Type of study/level of evidence: Prognostic II.

Keywords: Osteoporosis; distal radius fracture; functional outcome; local bone density; volar locking plate.

MeSH terms

  • Age Factors
  • Aged
  • Bone Density / physiology
  • Bone Plates*
  • Disability Evaluation
  • Female
  • Fracture Fixation, Internal*
  • Humans
  • Joint Instability / diagnostic imaging
  • Joint Instability / physiopathology
  • Joint Instability / surgery*
  • Logistic Models
  • Middle Aged
  • Osteoporosis, Postmenopausal / physiopathology*
  • Radius / diagnostic imaging
  • Radius Fractures / diagnostic imaging
  • Radius Fractures / physiopathology
  • Radius Fractures / surgery*
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Wrist Joint / physiopathology
  • Wrist Joint / surgery