Wrist Fractures Linked to Poor Balance in Older Patients
Older patients suffering a low-energy fracture of the distal radius are more likely to have difficulties with balance, placing them at risk for future injuries, according to a study appearing in the July 20 issue of The Journal of Bone and Joint Surgery.
The researchers evaluated 46 participants: 23 patients who had been treated for a wrist fracture within the past 6 to 24 months (age 65 or older at the time of injury), and 23 age- and sex-matched control participants without a prior fracture.
In the wrist fracture group, the injury was caused by a low-energy fall without a major traumatic event. Participants were excluded from the study if they had a history of an event or illness that impairs balance, such as a stroke, seizure, or vertigo.
All study participants received a dynamic motion analysis (DMA) score after assessment on a moving, computerized platform.
In addition, they were interviewed about their bone-health history, including whether they had undergone a dual x-ray absorptiometry scan (DXA) to evaluate for osteoporosis and whether they were taking vitamin D and calcium supplementation and/or medication for osteoporosis. The researchers also asked about prior falls and musculoskeletal injuries or conditions.
Participants completed common general health, physical activity, and health status surveys and tests as well.
Although there were no significant differences in age, sex, body mass index, physical activity score, or general health between groups, the fracture group demonstrated compromised balance with a higher DMA score – 933 points, on average, versus 790 points in the control group.
Nineteen patients (83%) in the fracture group reported having DXA imaging tests during the previous 5 years; however, only 2 patients (9%) had ever been referred for balance training with a physical therapist.
“Our study finds that older adults who sustain a wrist fracture are more likely to have poor balance compared to those who have not sustained this injury,” said lead study author Craig R. Louer, MD, an orthopaedic surgery resident at Washington University School of Medicine in St. Louis.
“These fractures should signal the need for an evaluation and possible treatment for balance deficits to decrease the risk of subsequent higher risk injuries, such as hip or spine fractures.”