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Considerations in the Treatment of Osteoporotic Distal Radius Fractures in Elderly Patients

  • Peter J. Ostergaard
  • Matthew J. Hall
  • Tamara D. RozentalEmail author
Distal Radius and Wrist Fractures (E Shin, section editor)
  • 28 Downloads
Part of the following topical collections:
  1. Topical Collection on Distal Radius and Wrist Fractures

Abstract

Purpose of Review

With the incidence of distal radius fractures increasing in the elderly population, we sought to summarize the current orthopedic and medical management of these fractures in the elderly osteoporotic population.

Recent Findings

The number of osteoporotic patients undergoing surgical fixation for distal radius fractures has increased in recent years. This is likely due to the improved outcomes seen with volar locking plates, as well as an increase in the number of fellowship-trained hand surgeons. Despite this potential improvement in acute fracture management, a majority of these patients are underdiagnosed and undertreated for their underlying osteoporosis or endocrinopathies. The implementation of fracture liaison services and the ability of the treating orthopedist to recognize this gap in patient care result in a higher number of patients initiating appropriate treatment.

Summary

It is vital that when discussing acute fracture management, a thorough discussion is had with patients regarding functional outcome and the benefits of both surgical and non-operative management. As these fractures become more prevalent and a greater percentage undergo surgical intervention, the economic burden of distal radius fractures will continue to rise. It is imperative that the treating surgeon view these fractures as sentinel events that are predictive of future hip and vertebral fractures. While relatively new, the use of fracture liaison services to help aide in proper screening and treatment of osteoporotic patients is of great value. Non-pharmacologic therapy such as physical therapy, smoking and alcohol cessation programs, and dietary modifications are crucial in treating patients with osteoporosis. While bisphosphonates remain the first-line treatment in patients with osteoporosis, novel therapies show promise for future use.

Keywords

Distal radius fractures Osteoporosis Elderly 

Notes

Compliance with Ethical Standards

Conflict of Interest

Peter J. Ostergaard, Matthew J. Hall, and Tamara D. Rozental declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Peter J. Ostergaard
    • 1
  • Matthew J. Hall
    • 1
  • Tamara D. Rozental
    • 2
    Email author
  1. 1.Harvard Combined Orthopaedic Residency ProgramHarvard Medical SchoolBostonUSA
  2. 2.Division of Hand and Upper Extremity Surgery, Department of Orthopedics, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonUSA

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