Parathyroid Hormone Disturbances in Postmenopausal Women with Distal Forearm Fracture

Abstract Background Primary hyperparathyroidism (PHPT) is a common endocrine disorder with a wide range of adverse effects, such as osteoporosis. Many women are not diagnosed due to asymptomatic disease or vague symptoms but are still at risk of severe adverse effects. Early identification of patients with PHPT is therefore of importance. The aim of this study was to determine PHPT prevalence among postmenopausal women with a distal forearm fracture. Methods Recruitment was conducted in conjunction with the occurrence of a distal forearm fracture at Karolinska University Hospital. In total, 161 postmenopausal women were included in a cross-sectional study with repeated evaluations. Analyzes of serum calcium, ionized calcium, phosphate, parathyroid hormone (PTH), and vitamin D were performed. Diagnosis of PHPT was based on clinical evaluations and biochemical definitions of serum calcium and PTH in coherence with previous population prevalence reports. Results Mean age was 64.7 (9.5) years, serum calcium 2.33 (0.10) mmol/L, ionized calcium 1.25 (0.05) mmol/L and PTH 54 (26) ng/L. PTH was elevated in 32 (20%) women. In total, 11 (6.8%) women were diagnosed with PHPT; 6 with classical PHPT and 5 with mild PHPT. The prevalence of PHPT was significantly increased compared to the population prevalence of 3.4% (p = 0.022). Conclusion Screening postmenopausal women in conjunction with low-energy distal forearm fracture revealed a large number of women with parathyroid disturbance. Evaluation of parathyroid hormone and calcium status in this group of patients seems beneficial.

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Osteoporosis health beliefs among postmenopausal women with a history of distal forearm fracture

Clinical Journal of Women s Health ◽

10.1053/cjwh.2002.124775 ◽

2002 ◽

Vol 2 (2) ◽

pp. 79-87 ◽

Cited By ~ 3

Author(s):

Maria-Teresa Cuddihy ◽

Sherine E. Gabriel ◽

Jeff A. Sloan ◽

Cynthia S. Crowson ◽

L. Joseph Melton

Keyword(s):

Postmenopausal Women ◽

Health Beliefs ◽

Forearm Fracture ◽

Distal Forearm ◽

Distal Forearm Fracture ◽

History Of

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Site-Specific Volumetric Skeletal Changes in Women with a Distal Forearm Fracture

Journal of Osteoporosis ◽

10.1155/2021/1578543 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Axel Wihlborg ◽

Karin Bergström ◽

Ingrid Bergström ◽

Paul Gerdhem

Keyword(s):

Postmenopausal Women ◽

Forearm Fracture ◽

Quantitative Computed Tomography ◽

Activity Level ◽

Low Energy ◽

Distal Forearm ◽

Distal Forearm Fracture ◽

Muscle Area ◽

Cross Sectional ◽

Site Specific

Purpose. To assess site-specific volumetric bone and muscle changes, as well as demographic and biochemical changes, in postmenopausal women with a low-energy distal forearm fracture. Methods. In a cross-sectional case-control study, postmenopausal women with a distal forearm fracture were compared with age- and gender-matched controls. In total, 203 postmenopausal women (104 cases and 99 controls), with a mean age of 65 years, were included. Measurements included peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA) as well as blood sampling and questionnaires. Results. Forearm trabecular volumetric BMD and total BMD assessed with pQCT were significantly lower in fracture cases compared to controls ( p < 0.001 ). Significantly higher cross-sectional area, lower cortical BMD, and lower cortical thickness were seen in women with fracture ( p < 0.033 , p < 0.001 , and p < 0.001 , respectively). Postmenopausal women with fracture had significantly lower hip and spine areal BMD assessed with DXA ( p < 0.001 ). Activity level was higher and a history of falling was more frequent in women with fracture ( p < 0.019 and p < 0.001 , respectively). Vertebral fracture was observed in 24 women (22%) with a distal forearm fracture. Muscle area, muscle density, PTH, and 25OHD did not differ between fracture cases and controls. Conclusion. A distal forearm fracture was associated with site-specific and central bone changes. Postmenopausal women with fracture had a larger bone area in combination with a thinner cortex and lower site-specific total BMD. In addition, women with fracture had a higher activity level, an increased occurrence of previous fall accidents, and a high prevalence of vertebral fractures. Forearm muscle composition, PTH, and 25OHD were not associated with forearm fracture. Fracture preventive measures following a low-energy distal forearm fracture seem beneficial.

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X-ray Follow-up after Open Reduction Internal Fixation of Distal Forearm Fracture

Journal of Wrist Surgery ◽

10.1055/s-0040-1721139 ◽

2020 ◽

Author(s):

Henrik Johan Sjølander ◽

Sune Jauffred ◽

Michael Brix ◽

Per H. Gundtoft

Keyword(s):

Diagnostic Imaging ◽

Forearm Fracture ◽

Minimal Risk ◽

Distal Forearm ◽

Forearm Fractures ◽

Distal Forearm Fracture ◽

Standard Regimen ◽

Prolonged Immobilization ◽

Distal Forearm Fractures

Abstract Background Following surgery, the standard regimen for fractures of the distal forearm includes radiographs taken 2-weeks postoperatively. However, it is unclear whether these radiographs have any therapeutic risks or benefits for patients. Objective The purpose of this study is to determine the importance of radiographs taken 2-weeks after surgery on distal forearm fractures, especially if it leads to further operations, and to establish whether this practice should be continued. Materials and Methods This is a retrospective cohort study of patients with a distal forearm fracture treated surgically with a volar locking plate at two university hospitals in Denmark. Standard aftercare at both departments is 2 weeks in a cast. Patients attend a 2-week follow-up, at which the cast is replaced with a removable orthosis and radiographs are taken. It was recorded whether these radiographs had resulted in any change of treatment in terms of further operations, prolonged immobilization, additional clinical follow-up, or additional diagnostic imaging. Results A total of 613 patients were included in the study. The radiographs led to a change of standard treatment for 3.1% of the patients. A second operation was required by 1.0%; 0.5% were treated with prolonged immobilization, and 1.6% had additional outpatient follow-up due to the findings on the radiographs. Additional diagnostic imaging was performed on 1.9% of the patients. Conclusion The radiographs taken at the 2-weeks follow-up resulted in a change of treatment in 3.1% of the cases. Given the low cost and minimal risk of radiographs of an extremity, we concluded that the benefits outweigh the costs of routine radiographs taken 2 weeks after surgical treatment of distal forearm fractures.

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