Epidemiology
One prospective multi-centre study in the UK reported that the incidence of distal radius fractures is 36.8/10,000 person-years in women and 9.0/10,000 person-years in men over 35 years of age.[10] Another prospective study in the UK reported the incidence of distal radius fractures as 127.9 per 100,000 person-years for all patients, 83.3 per 100,000 person-years for patients under 50 years, and 184.7 per 100,000 person-years for patients over the age of 50 years.[11] For women of any age, the study reported the incidence as 170.2, and for men of any age as 83.9 per 100,000 person-years.[11]
Distal radius fractures have a bi-modal distribution in the population.[1][12]
Women with osteoporosis, in their sixth or seventh decade of life, represent the most predominant group, typically having sustained the fracture after a fall from a standing height.[1][13][14] These are largely considered low-energy injuries, and the male-to-female ratio is 1:4.[15]
Young men in their second and third decades of life form the second most predominant group. This population is very different, as they have denser bone, and injuries are typically associated with high-energy mechanisms.[12][15][16]
Risk factors
Wrist fractures are almost always as a result of trauma, although in rare situations, patients with osteoporosis are known to develop atraumatic insufficiency fractures.
Osteopenia is associated with a higher risk for a distal radius fracture.[18][19][20]
Increasing data show that in older people with osteopenia, a prior wrist fracture has a well-defined relationship with an osteoporotic fracture in other locations. Furthermore, in patients with a wrist fracture, the risk of a hip fracture increases 1.4- to 1.8-fold in women and 2.3- to 2.7-fold in men.[21][22][23]
Consider osteoporosis in a patient with a low-energy mechanism of injury, such as a fall from standing height.
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