A UCLA-led study suggests that wrist fractures among postmenopausal women who are younger than 65 may predict more serious fractures in other parts of their bodies later in life.
The researchers found that one-in-five women who had experienced a broken wrist went on to suffer a non-wrist fracture during the next 10 years. They also suggested that women who broke a wrist stood a 40-percent higher chance of breaking other bones during the subsequent 11 years compared with women who did not break a wrist.
“Our results emphasize that wrist fractures do identify a group of women at particular risk for future fracture,” says Carolyn Crandall, MD ’91 (RES ’94), professor of medicine. “The information highlights the great importance of working to develop strategies to prevent future fractures after an initial wrist fracture occurs.”
The researchers used information from the Women’s Health Initiative (WHI), whose participants were aged 50 to 79 at the start of the study in 1993. More than 160,000 women answered annual questionnaires detailing the fractures they experienced during more than a decade of follow-ups.
They found that having a wrist fracture was associated with: a 50-percent higher risk of subsequent spine fractures; an 80-percent higher risk for upper-arm fractures; a 90-percent higher risk of a lower-arm non-wrist fracture; a 40-percent higher risk of leg fractures; and a 50-percent higher risk of hip fractures. These associations persisted even after adjusting for factors such as bone-mineral density, physical activity, smoking and alcohol use, calcium and vitamin D intake, falls and all other known fracture-risk factors.
The study has some limitations. Self-reporting of fractures may not be as accurate as medically verified breaks, but misclassifications of fractures in the WHI have been low; WHI participants may be healthier than other women, so these findings may not be representative of postmenopausal women as a whole, and the number of women who had normal bone-mineral density but nonetheless suffered wrist fractures was low.
But the findings do indicate a “substantial missed opportunity” to devise interventions to prevent subsequent fractures in women who experienced a wrist fracture, the researchers write. Among postmenopausal women who have experienced wrist fractures, those who have a bone-mineral-density T-score less than or equal to -1.0 should be diagnosed as having osteoporosis, they write.
“Wrist Fracture and Risk of Subsequent Fracture: Findings from the Women’s Health Initiative Study,” Journal of Bone and Mineral Research, November 2015