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Tahir Masud, Desda Jordan, David J. Hosking, Distal forearm fracture history in an older community‐dwelling population: the Nottingham Community Osteoporosis (NOCOS) study, Age and Ageing, Volume 30, Issue 3, May 2001, Pages 255–258, https://doi.org/10.1093/ageing/30.3.255
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Abstract
Objectives: to assess the prevalence of a history of Colles' fracture (occurring after the age of 40 years) and to ascertain the extent of investigation and treatment of osteoporosis in this population.
Methods: we studied subjects aged ≥60 years from the age–sex register of three general practices. We recorded a history of fractures and details of any previous investigation for osteoporosis and treatment with bone‐protective drugs. Bone mineral density was performed at the heel using dual‐energy x‐ray absorptiometry (Lunar PIXI machine). We classified subjects into normal, osteopaenic or osteoporotic according to the machine manufacturer's recommended World Health Organisation ‘equivalent T‐score thresholds’ (0.6 for osteopaenia and 1.6 for osteoporosis).
Results: of the 605 subjects invited, we recruited 259 women and 194 men (response rate=74.8%). Twenty‐eight (10.8%) of the women and five (2.6%) of the men had a history of Colles' fracture. Of women with a prevalent Colles' fracture, 39% were osteoporotic and 36% were osteopaenic. These rates were significantly greater than in women without a Colles' fracture (19.9% osteoporotic, 29.4% osteopaenic; P=0.018). Assuming the same PIXI thresholds for men, two (40%) of the five men with a history of Colles' fractures were osteoporotic and the rest were osteopaenic, compared with 20.6 and 31.2% of men without a history of Colles' fractures. None of the subjects in the Colles' fracture group had previously been investigated with bone densitometry. Women with and without a history of Colles' fracture did not differ significantly in ever having (32.1% vs 27.2%; P=0.4) or currently having (14.3% vs 10.4%; P=0.4) hormone replacement treatment. None of the men and only one woman with a previous Colles' fracture had ever taken a non‐hormone replacement treatment for osteoporosis.
Conclusions: older community‐dwelling subjects with previous Colles' fracture have a high prevalence of osteoporosis and are under‐investigated and under‐treated. Methods for identifying subjects with a previous Colles' fracture need to be developed in primary and secondary care.
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