Fractured Wrists - the Canaries in the Coal Mine
The expression, “the canary in the coal mine” comes from a long ago practice of coalminers bringing canaries with them into the coalmines. These birds were more sensitive than humans to toxic gasses and so, if they became ill or died, the coalminers knew they had to get out quickly. The canaries were a kind of early warning signal before it was too late. Even though the practice has been discontinued, the metaphor lives on as a warning of possible serious danger to come.
Osteoporosis, which means porous bones, has been called a silent disease because often an individual doesn’t know he or she has it until they break a bone. The three common areas of fracture are the wrist, the hip, and the spine. Osteoporosis fractures are called fragility fractures, meaning they happen from a fall of standing height or less. We should not break a bone just by a fall unless there is an underlying cause which makes our bones fragile.
Wrist fractures typically happen when a person starts to fall and puts his or her arms out to catch themselves. They often are seen in the Emergency Department but seldom followed up with an Osteoporosis workup. According to the International Osteoporosis Foundation’s Capture the Fracture program, 80% of fracture patients are never offered screening and / or treatment for osteoporosis.
Below are some signs to be aware of:
1. The three most common signs of osteoporosis:
a. History of fractures
b. Hyper-kyphosis of the thoracic spine (Dowagers Hump)
c. Loss of height equal or greater than 1 ½ inches.
2. Grip Strength
Low grip strength in women is associated with low bone density (1)
A prior fragility fracture is associated with an 86% increased risk of any future fracture based on a 2004 meta-analysis by Kanis, Johnell, and De Laet in Bone (2). Fracture predicts fracture. Fractures from osteoporosis can be devastating, resulting in a diminished quality of life at best and an increased risk of mortality at worst. If you have suffered a fragility fracture, speak to your doctor about ordering a Bone Density Test (DXA Scan) to determine your bone health. It’s important to know before another fracture occurs.
References:
Dixon WG et al. Low grip strength is associated with bone mineral density and vertebral fracture in women. Rheumatology 2005;44:642-646
Kanis JA, Johnell O, De Laet C, et al. (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375