Does Osteoporosis or Vitamin D Affect the Severity of Minimal Trauma Distal Radius Fractures? A Prospective Cohort Study

Objectives: Distal radius fractures (DRF) account for the greatest percentage of upper limb fractures. Osteoporosis and hypovitaminosis D have been associated with increased risk of minimal trauma DRF, however there is limited data regarding their impact on the severity of DRF. The aim of this study was to evaluate whether osteoporosis and vitamin D levels influenced the severity of minimal trauma distal radius fracture as measured by AO/OTA classification, treatment received and functional outcomes.
Methods: This is a prospective cohort study consisting of 45 patients over the age of 50 who presented with minimal trauma DRF. Bone mineral density (BMD) and serum vitamin D levels were obtained in conjunction with routine patient care, whilst fractures were evaluated using the AO/OTA classification on plain film. Patients completed the DASH and PRWE questionnaires at least 12 months post injury.
Result: 18 of the 45 patients were found to be osteoporotic, with only 3 being known osteoporotic prior to their DRF. There was no association between BMD and serum vitamin D in this population (P = 0.257). Osteoporosis or hypovitaminosis D did not impact the classification of fracture, treatment received or long-term functional outcomes.
Conclusion: BMD and serum vitamin D levels do not appear to influence the severity of DRF in patients with minimal trauma injury over the age of 50. Vitamin D was not a strong predictor of BMD in this cohort, with socioenvironmental factors a potential reason. Minimal trauma DRF should be utilised as an early opportunity to screen for osteoporosis.
Level of Evidence: Level II

Keywords: Osteoporosis; Vitamin D; Distal Radius Fracture; Severity; Functional Outcomes