Vertebral morphometric X-ray absorptiometry in women with Colles' fracture

Colles' fracture (CF) in younger postmenopausal women is associated with low bone mineral density (BMD) and with an increased risk of other osteoporotic fractures; however, the prevalence of vertebral deformities has been not studied in CF patients. Vertebral morphometry (MXA) using dual-energy X-ray absorptiometry (DXA) is a research tool developed to evaluate the presence of vertebral deformities, but its clinical use is still limited. The goals of this work were to know the prevalence of vertebral deformities in women with CF, to study the morphometric characteristics of height ratios, and to determine the correlation between MXA findings and BMD. MXA was evaluated within an incident case-control study in which 58 women with a recent CF and 83 population-based control women were enrolled. Anterior (Ha), middle (Hm), and posterior (Hp) heights were measured, and wedge (Ha/Hp) and mid-wedge (Hm/Hp) ratios were calculated. A vertebral deformity was defined when at least one ratio fell 3 SD below the reference mean of that ratio at any vertebral level. The mean age of cases was 65.8 yr and in controls 58.7 (p < 0.05). Morphometric vertebral deformities were found in 19% of cases against 11% of controls (nonsignificant). The cases had a lower mid-wedge ratio than controls at each vertebral level (p < 0.05), while wedge ratio results did not show significant results. When the sample was stratified by age, CF showed a trend to be associated with vertebral deformity only in the younger (<65 yr) group. A low but significant coefficient of correlation was found between mid-wedge ratio and BMD, mainly at hip level. By using MXA we found that younger Colles' fracture cases were likely to have more vertebral deformities than healthy controls of the same age range.