Review Article

The Effect of Osteoporosis on the Pathogenesis and Healing of Distal Radius Fragility Fractures

Alexandros Avgerinos^1,2

1. Department of Orthopedics, General Hospital of Chania “St. George”, Crete, Greece
2. Postgraduate Program “Metabolic Bone Diseases”, National and Kapodistrian University of Athens, Medical School, Athens, Greece

---

Keywords: Distal radius fracture, Osteoporosis, Pathogenesis, Healing

---

Abstract

Osteoporosis is a significant predisposing factor for fragility fractures of the distal radius. The disorder is characterized by a significant and long-standing imbalance between bone formation and absorption, resulting in a gradual reduction in bone mass that worsens with age. This narrative review aims to present recent data regarding the effect of osteoporosis on the pathogenesis and healing of distal radius fragility fractures. Although research on this topic is limited, current studies suggest that during the osteopenia or osteoporosis stage, both trabecular and cortical bone undergo quantitative and qualitative changes. As a result, a weak cortex shell surrounds the trabecular bone compartment which exhibits significant deterioration of its microarchitecture, with cortical bone being the most critical factor in resisting distal radius fractures in the early stages of osteopenia. Concerning fracture healing, and based on limited published data, it is believed that osteoporosis does not have a significant impact on the progression of fracture healing in distal radius fractures, although there appears to be a tendency towards a potential negative effect. The treating physician must consider the unique characteristics of osteoporotic bone, including reduced healing ability and relatively lower functional requirements of patients. Balancing these factors is crucial in determining an appropriate treatment plan.

---