Forearm Fractures as Predictors of Subsequent Osteoporotic Fractures

Cuddihy, Maria-Teresa; Gabriel, Sherif E.; Crowson, Cynthia S.; O’Fallon, W. Michael; Melton, L. Joseph

doi:10.1007/s001980050263

Cited by 46 publications

(74 citation statements)

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“…This is consistent with previous reports, which suggest that osteoporotic fractures tend to occur in clusters and that the occurrence of a fracture usually indicates an increased risk of subsequent fracture at other sites [5,14,15].…”

Section: Discussionsupporting

confidence: 93%

Epidemiology of osteoporotic hip fractures in Spain

Herrera

Martı́nez

Ferrández³

et al. 2005

International Orthopaedics (SICO

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We conducted a multicentre study, divided into a retrospective and a prospective portion. The retrospective study evaluated osteoporotic hip fractures that occurred during 2002. The prospective study evaluated osteoporotic hip fractures that occurred during May 2003. The study was conducted in 77 hospitals in Spain and comprised patients 60 years of age and over. In the retrospective study we registered 13,195 hip fractures. Of the patients, 74% were women and 26% were men. The mean age was 80.7±8.4 years. The average incidence was 6.94±0.44 hip fractures per 1,000 inhabitants/year (95% CI, 6.07-7.82). In the prospective study, we registered 1,399 hip fractures. This represents a monthly incidence of 0.60±0.04 hip fractures per 1,000 inhabitants/year (95% CI, 0.51-0.69). Of the subjects, 74% were women and 26% were men. The mean age was 81.4±8

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Section: Discussionsupporting

confidence: 93%

Epidemiology of osteoporotic hip fractures in Spain

Herrera

Martı́nez

Ferrández³

et al. 2005

International Orthopaedics (SICO

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“…57,58 Forearm fractures in adults, particularly when associated with minor trauma, are considered to be indicators of poor bone health and predictors of future osteoporosis-related fractures. 7,8 Our data, as well as those of previous studies, suggest that a forearm fracture during childhood may be a similar pediatric marker indicative of suboptimal bone health status.…”

Section: Discussionsupporting

confidence: 83%

“…In adults, forearm fractures are associated with bone health deficits, including lower bone mineral density (BMD), and are predictors of future osteoporosis-related fractures. [7][8][9][10] Similarly, studies of predominantly healthy white children with forearm fractures demonstrate an association with lower BMD relative to peers without forearm fractures. [11][12][13][14][15][16] Other factors associated with forearm fracture risk in white children include low dietary calcium intake, 17 low dietary milk intake, 17 and high BMI.…”

mentioning

confidence: 97%

Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

Ryan¹,

Teach²,

Singer

et al. 2012

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Forearm fractures are unique injuries which are associated with lower bone mineral density in adults and white children. The relationships among bone mineral density, 25-hydroxyvitamin D status, and risk for forearm fracture have not been investigated in African American children. WHAT THIS STUDY ADDS:Our data support an association between both lower bone mineral density and vitamin D deficiency and increased odds of forearm fracture in African American children. Promotion of bone health is indicated in this population.abstract OBJECTIVE: To determine whether African American children with forearm fractures have decreased bone mineral density and an increased prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D level #20 ng/mL) compared with fracture-free control patients. METHODS:This case-control study in African American children, aged 5 to 9 years, included case patients with forearm fracture and control patients without fracture. Evaluation included measurement of bone mineral density and serum 25-hydroxyvitamin D level. Univariable and multivariable analyses were used to test for associations between fracture status and 2 measures of bone health (bone mineral density and 25-hydroxyvitamin D level) while controlling for other potential confounders. RESULTS:The final sample included 76 case and 74 control patients. There were no significant differences between case and control patients in age, gender, parental education level, enrollment season, outdoor play time, height, or mean dietary calcium nutrient density. Cases were more likely than control patients to be overweight (49.3% vs 31.4%, P = .03). Compared with control patients, case patients had lower whole body z scores for bone mineral density (0.62 6 0.96 vs 0.98 6 1.09; adjusted odds ratio 0.38 [0.20-0.72]) and were more likely to be vitamin D deficient (47.1% vs 40.8%; adjusted odds ratio 3.46 [1.09-10.94]). CONCLUSIONS:These data support an association of lower bone mineral density and vitamin D deficiency with increased odds of forearm fracture among African American children. Because suboptimal childhood bone health also negatively impacts adult bone health, interventions to increase bone mineral density and correct vitamin D deficiency are indicated in this population to provide short-term and long-term benefits. Pediatrics 2012;130:e553-e560

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“…However, different fractures seem to have different predictive value. After a forearm fracture, the risk of future hip fractures was found to be increased by only 40% according to Cuddihy et al (1999), while a vertebral fracture in a postmenopausal woman has been reported to predict a 4-times higher risk of new vertebral fractures and a 2-fold higher risk of hip fracture than in women with no previous fracture (Klotzbuecher et al 2000).…”

Section: Previous Fracture Can Be Used As a Predictor Of Future Fractmentioning

confidence: 99%

Women with low-energy fracture should be investigated for osteoporosis

et al. 2007

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Introduction Treatment of osteoporosis is becoming more effective, but methods to identify patients who are most suitable for investigation and treatment are still being debated. Should any type of fracture have higher priority for investigation of osteoporosis than any other? Is the number of previous fractures useful information?Material and methods We investigated 303 consecutive women patients between 55 and 75 years of age who had a newly diagnosed low-energy fracture. They answered a questionnaire on previous fractures which also dealt with risk factors. Bone mineral density (BMD) was measured at the hip, lumbar spine, and forearm.Results The distribution of fracture location was: distal forearm 56%, proximal humerus 12%, vertebra 18%, and hip 13%, all with similar age. Half of the subjects had had at least one previous fracture before the index fracture, 19% had had two previous fractures, and 6% had had three or more previous fractures. Patients with vertebral or hip fracture had lower BMD and had had more previous fractures than patients with forearm or humerus fractures. There was an inverse correlation between number of fractures and BMD. Osteoporosis was present in one-third of patients with forearm fracture, in one-half of those with hip or humerus fracture, and in two-thirds of those with vertebral fracture.Interpretation Vertebral fractures were the strongest marker of low BMD and forearm fractures the weakest. The number of previous fractures is helpful information for finding the most osteoporotic patient in terms of severity. Investigation of osteoporosis therefore seems

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Forearm Fractures as Predictors of Subsequent Osteoporotic Fractures

Cited by 46 publications

References 0 publications

Epidemiology of osteoporotic hip fractures in Spain

Epidemiology of osteoporotic hip fractures in Spain

Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

Women with low-energy fracture should be investigated for osteoporosis

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