• A M Daniels, JanzingH M JHMJDepartment of Surgery, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands., C E Wyers, B van Rietbergen, L Vranken, R Y Van der Velde, GeusensP P M MPPMMDepartment of Internal Medicine, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.Faculty of Medicine, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium., S Kaarsemaker, M Poeze, and J P Van den Bergh.
• Department of Surgery, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands. adaniels@viecuri.nl.
• Arch Orthop Trauma Surg. 2021 Nov 1; 141 (11): 1909-1918.

IntroductionThe aim of this study was to investigate the associations of patient characteristics, bone mineral density (BMD), bone microarchitecture and calculated bone strength with secondary displacement of a DRF based on radiographic alignment parameters.Materials And MethodsDorsal angulation, radial inclination and ulnar variance were assessed on conventional radiographs of a cohort of 251 patients, 38 men and 213 women, to determine the anatomic position of the DRF at presentation (primary position) and during follow-up. Secondary fracture displacement was assessed in the non-operatively treated patients (N = 154) with an acceptable position, preceded (N = 97) or not preceded (N = 57) by primary reduction (baseline position). Additionally, bone microarchitecture and calculated bone strength at the contralateral distal radius and tibia were assessed by HR-pQCT in a subset of, respectively, 63 and 71 patients.OutcomeCharacteristics of patients with and without secondary fracture displacement did not differ. In the model with adjustment for primary reduction [OR 22.00 (2.27-212.86), p = 0.008], total [OR 0.16 (95% CI 0.04-0.68), p = 0.013] and cortical [OR 0.19 (95% CI 0.05-0.80], p = 0.024] volumetric BMD (vBMD) and cortical thickness [OR 0.13 (95% CI 0.02-0.74), p = 0.021] at the distal radius were associated with secondary DRF displacement. No associations were found for other patient characteristics, such as age gender, BMD or prevalent vertebral fractures.ConclusionsIn conclusion, our study indicates that besides primary reduction, cortical bone quality may be important for the risk of secondary displacement of DRFs.© 2020. The Author(s).

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