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<i>Summary</i> <p>Distal radius fractures may indicate underlying osteoporosis. In 856 surgical patients ≥ 50&#xa0;years, DXA testing rose from 19.0 to 85.7%; 64.5% had osteoporosis and 36.3% had fracture risk. Many were previously untreated. Routine DXA screening for all DRF patients ≥ 50, including men, may enable early treatment and secondary fracture prevention.</p> Purposes <p>The objective was to investigate the dual-energy X-ray absorptiometry (DXA) examination rate, osteoporosis diagnosis rate, and osteoporosis severity in distal radius fracture (DRF) at a trauma flagship hospital.</p> Methods <p>We retrospectively examined 856 DRF patients aged 50&#xa0;years or older (723 women, 133 men; mean 71.8&#xa0;years) who underwent surgery between 2007 and 2025. We evaluated the presence of DXA testing, osteoporosis diagnosis (<i>T</i>-score ≤ −2.5SD), and osteoporosis with high fracture risk, including (1) L-spine <i>T</i>-score &lt; −3.3SD, (2) <i>T</i>-score ≤ −2.5SD with at least one fragility fracture, (3) two or more vertebral fractures, or (4) semiquantitative grade 3 vertebral fracture. Subgroup comparisons were according to sex, age, and mechanism of injury (low vs. high energy). The chi-square test and Cochran-Armitage test were used for statistical analysis.</p> Results <p>DXA implementation rate was 31.0% and increased significantly from 19.0% in 2007 to 85.7% in 2025. This rate was significantly higher in women (34.2%) than men (13.5%). Of those tested, 64.5% were diagnosed with osteoporosis (women 65.2%, men 55.6%). Osteoporosis was observed in over half of patients even in 50&#xa0;s (57.1%) and with high-energy injuries (56.5%). Among osteoporosis patients, 81.9% had not received prior treatment for osteoporosis, and 90% of untreated cases subsequently initiated treatment. Fracture risk was estimated in 36.3% of osteoporosis cases.</p> Conclusion <p>These results revealed a high prevalence of latent osteoporosis, regardless of age, sex, or injury mechanism. DXA testing should be recommended to prevent secondary fragility fractures for all DRF patients aged 50 and older, including males.</p>

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Trend in DXA examination rates and the prevalence of osteoporosis in patients with distal radius fractures at a trauma flagship hospital

  • 期刊论文

  • 发表日期：

    2026年5月7日

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  • Yusuke Kubo,
  • Kazuhiko Sonoda,
  • Toshihiko Hara

摘要

Summary

Distal radius fractures may indicate underlying osteoporosis. In 856 surgical patients ≥ 50 years, DXA testing rose from 19.0 to 85.7%; 64.5% had osteoporosis and 36.3% had fracture risk. Many were previously untreated. Routine DXA screening for all DRF patients ≥ 50, including men, may enable early treatment and secondary fracture prevention.

Purposes

The objective was to investigate the dual-energy X-ray absorptiometry (DXA) examination rate, osteoporosis diagnosis rate, and osteoporosis severity in distal radius fracture (DRF) at a trauma flagship hospital.

Methods

We retrospectively examined 856 DRF patients aged 50 years or older (723 women, 133 men; mean 71.8 years) who underwent surgery between 2007 and 2025. We evaluated the presence of DXA testing, osteoporosis diagnosis (T-score ≤ −2.5SD), and osteoporosis with high fracture risk, including (1) L-spine T-score < −3.3SD, (2) T-score ≤ −2.5SD with at least one fragility fracture, (3) two or more vertebral fractures, or (4) semiquantitative grade 3 vertebral fracture. Subgroup comparisons were according to sex, age, and mechanism of injury (low vs. high energy). The chi-square test and Cochran-Armitage test were used for statistical analysis.

Results

DXA implementation rate was 31.0% and increased significantly from 19.0% in 2007 to 85.7% in 2025. This rate was significantly higher in women (34.2%) than men (13.5%). Of those tested, 64.5% were diagnosed with osteoporosis (women 65.2%, men 55.6%). Osteoporosis was observed in over half of patients even in 50 s (57.1%) and with high-energy injuries (56.5%). Among osteoporosis patients, 81.9% had not received prior treatment for osteoporosis, and 90% of untreated cases subsequently initiated treatment. Fracture risk was estimated in 36.3% of osteoporosis cases.

Conclusion

These results revealed a high prevalence of latent osteoporosis, regardless of age, sex, or injury mechanism. DXA testing should be recommended to prevent secondary fragility fractures for all DRF patients aged 50 and older, including males.