Evaluation and Management of Osteoporosis and Sarcopenia in Patients with Distal Radius Fractures

Abstract

The World Health Organization has defined osteoporosis as a metabolic bone disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and a consequent increase in frac ture risk. 1) It has been estimated that more than 200 million people are suffering from osteoporosis. n 2008, about 40% of women in Korea were reported to have osteoporosis. 3) On the other hand, sarcopenia is defined as the loss of muscle mass and muscle strength and functional impairment of muscles with aging, which compromises physical performance. It is closely associated with fractures and has been investigated as a new independent risk factor for fragility fractures, leading to a condition known as osteosarcopenia. Osteoporosis and sarcopenia are predominantly common in older individuals, resulting in increased morbidity, mortality, and healthcare costs. istal radius fractures (DRFs) are the most common upper extremity fracture in middle-aged and elderly people with an overall higher incidence in women. 8) The incidence of DRFs is rising in recent decades. A study from the USA found a 17% increase in the incidence of this injury over a 40-year period, and in Sweden the incidence almost doubled for the older population over a 30-year time span. The proportion of DRFs treated by surgery tended to increase over time, from 32.6% in 2011 to 38.3% in 2015 in Korea. 11) Osteoporosis is an independent risk factor for lowenergy DRFs in the elderly population and hence should not be missed in managing DRFs. Studies have shown that patients with DRFs have a high incidence of osteoporosis and an increased risk of subsequent fractures, subtle early physical performance changes, and a high prevalence of sarcopenia. Since DRFs typically occur 15 years earlier than hip fractures, they reflect early changes of the bone and muscle frailty and provide physicians with an opportunity to prevent progression of frailty and secondary fractures. Since our last review on the evaluation of bone

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