Bone Fragility, Fracture Risk and Trauma:a Complicated Triangle in Children

Abstract

Objective: To analyze whether association between bone fragility and risk of fracture depends on the trauma level. Method: All participants along with their mothers underwent DXA scan and body measurements. The subjects answered a self-report questionnaire about their physical activities and the precipitating causes. The questionnaire results were associated with DXA performed at the baseline visit.Results: A total 374 children with available DXA scan and complete follow-up of 5 years were included in the final analysis. Of the 374 children, 53 (14.2%) had one fracture, and 11 (20.7%) had more than one fracture. Based on the modified Landin classification, the trauma level was determined. Of the 53 (14.2%) children who had one fracture, 39 (73.6%) were classified, namely 19 (48.7%) with mild trauma, 16 (41%) with moderate trauma and four (10.2%) with severe trauma. Trauma level could not be assigned to 14 (26.4%) children due to limited information. Children without fractures had significantly higher values in all bone parameters compared to those with fractures caused by mild trauma. Conclusion: Subjects with mild trauma fractures had an inversely proportional ratio between bone fragility parameters and fracture risk compared with subjects without fractures. Level of Evidence IV, Case Series.

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