Osteoporosis International · Oct 27, 2026

Clinical role and timing of osteoporosis evaluation and treatment after distal radius fracture: a scoping review

By Kwon BC, Cho S, Chae S et al.

UNLABELLED: Distal radius fracture is an early fragility fracture, yet evidence guiding osteoporosis treatment afterward is unclear. In this scoping review of 250 reports, post-fracture osteoporosis care was associated with fewer subsequent fractures in observational studies, but no randomized distal radius fracture-specific trial exists and normal-bone-mineral-density patients remain understudied. PURPOSE: To map the extent, range, and nature of evidence on the clinical role and timing of osteoporosis evaluation and treatment after distal radius fracture (DRF). METHODS: We conducted a JBI-guided scoping review reported per PRISMA-ScR (prospectively registered on OSF). PubMed, OpenAlex, Europe PMC, Embase, the Cochrane Database of Systematic Reviews, KoreaMed, and CiNii were searched on 4 May 2026 for adults aged ≥50 years with DRF or wrist fragility fracture. Records underwent dual large language model screening, independently audited in duplicate by two authors, and source-verified charting, synthesized descriptively without pooling. RESULTS: Across 250 reports (2008-2026), evidence addressed BMD-based risk and selection (103), the care gap (65), prognosis (40), and treatment (42). Median DXA testing and treatment-initiation rates were 26% and 22%. Eleven observational reports linked treatment or structured care to fracture outcomes; a separate economic model projected outcomes. Estimates were heterogeneous and not pooled. No included study directly compared early versus delayed treatment initiation after DRF with subsequent fracture as the outcome. Six reports focused on normal BMD; none estimated subgroup-specific fracture outcomes. CONCLUSION: A fragility DRF warrants prompt secondary prevention, assessment for secondary causes, and timely indicated treatment. DXA and FRAX can inform individualized decisions but should not delay indicated care. Observational associations do not establish a causal treatment effect; optimal timing and benefit in normal-BMD patients remain unresolved.

doi.org/10.1007/s00198-026-08296-9 PubMed 42946792 Interventions