Hand Dominance and Bone Response After a Distal Radial Fracture: A peripheral QCT Study

Abstract 

There are no reports on bone geometry or volumetric bone density adaptations in those who have sustained a distal radial fracture. We used peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA) to quantify bone and muscle response to immobilization. We measured side–side differences in women aged ≥50yr who had previously sustained a wrist fracture (4.0±3.5 mean yr since fracture). We used pQCT and DXA to measure bone in 31 women (mean age 72.4±9.7yr) at the 4% and 30% sites of bilateral radii; measured grip strength and functional outcome. Initially, we compared the fractured side to intact side and did not control for hand dominance. We observed greater total area (ToA) at the distal (4%) radius on the fractured side without a significant increase in density. At the midshaft (30% site), we observed significantly less ToA and cortical bone on the fracture side. Grip strength was also significantly less on the fractured side (p<0.01). We assessed dominant side fractures and nondominant fractures separately. We observed a greater discrepancy between limbs with a nondominant side fracture, even after accounting for dominance. This cross-sectional study suggests that the bone response to a nondominant fracture may differ from a dominant fracture.

Key Words: pQCT, DXA, fracture, immobilization