A distal radius fracture after 65 is a window for osteoporosis treatment most patients miss; WAIT-Free sets out immediate weight-bearing after hip fracture for Asia

The edition in brief

In a propensity-matched Japanese claims cohort of 47,178 adults aged 65 to 89, those with a distal radius fracture had more subsequent hip fractures than controls with an arm contusion (2.58 vs 2.00 per 100 person-years), yet only 17.6% began osteoporosis treatment within a year; mortality was not higher after adjustment (HR 0.98, 0.93 to 1.02), suggesting these patients are fragile-boned but still functional. The WAIT-Free consensus, from 31 experts in 15 countries, gives 13 recommendations for bringing immediate weight-bearing as tolerated after hip fracture surgery to regions where it is not routine, including South Asia. In a US registry of 13,901 shoulder replacements, Exactech Equinoxe anatomic implants had higher revision risk than other devices (HR 1.87, 1.33 to 2.62), while reverse arthroplasty did not differ. In 5653 primary ACL reconstructions, quadriceps tendon grafts had more reoperations for extension deficit or pain than hamstring grafts (11.9% vs 5.5%; adjusted OR 1.96). A meta-analysis of seven mostly nonrandomised studies associated robotic hip arthroplasty with about 2 mm less leg-length discrepancy and modestly better early scores. The practical message: treat the bone after a wrist fracture, and let independently mobile hip fracture patients bear weight straight away.