Document Detail

A distal forearm fracture in childhood is associated with an increased risk for future fragility fractures in adult men, but not women.
MedLine Citation:
PMID:  23456800     Owner:  NLM     Status:  MEDLINE    
Distal forearm fractures are among the most common fractures during childhood, but it remains unclear whether they predict an increased fracture risk later in life. We studied a population-based cohort of 1776 children ≤18 years of age, from Olmsted County, MN, USA, who had a distal forearm fracture in 1935-1992. Incident fractures occurring at age ≥35 years were identified through review of complete medical records using the linkage system of the Rochester Epidemiology Project. Observed nonpathologic fractures resulting from no more than moderate trauma (fragility fractures) were compared with expected numbers estimated from fracture site-specific incidence rates, based on age, sex, and calendar year, for Olmsted County (standardized incidence ratios [SIR]). In 1086 boys (mean ± SD age; 11 ± 4 years) and 690 girls (10 ± 4 years) followed for 27,292 person-years after the age of 35 years, subsequent fragility fractures were observed in 144 (13%) men and 74 (11%) women. There was an increased risk for future fragility fractures in boys who had a distal forearm fracture (SIR, 1.9; 95% CI, 1.6-2.3) but not girls (SIR, 1.0; 95% CI, 0.8-1.2). Fragility fractures at both major osteoporotic (hip, spine, wrist, and shoulder) sites (SIR, 2.6; 95% CI, 2.1-3.3) and remaining sites (SIR, 1.7; 95% CI, 1.3-2.0) were increased in men, irrespective of age at distal forearm fracture as boys. A distal forearm fracture in boys, but not girls, is associated with an increased risk for fragility fractures as older adults. It is necessary to determine whether the increased fractures observed in men is due to persistent deficits of bone strength, continued high fracture risk activity, or both. Until then, men should be asked about a childhood distal forearm fracture and, if so, warrant further screening and counseling on measures to optimize bone health and prevent fractures.
Shreyasee Amin; L Joseph Melton; Sara J Achenbach; Elizabeth J Atkinson; Mark B Dekutoski; Salman Kirmani; Philip R Fischer; Sundeep Khosla
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research     Volume:  28     ISSN:  1523-4681     ISO Abbreviation:  J. Bone Miner. Res.     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-07-22     Completed Date:  2014-02-26     Revised Date:  2014-08-04    
Medline Journal Info:
Nlm Unique ID:  8610640     Medline TA:  J Bone Miner Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1751-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 American Society for Bone and Mineral Research.
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MeSH Terms
Forearm Injuries / epidemiology*
Fractures, Bone / epidemiology*
Minnesota / epidemiology
Risk Factors
Sex Characteristics
Grant Support
P01 AG004875/AG/NIA NIH HHS; P01 AG004875/AG/NIA NIH HHS; R01 AG034676/AG/NIA NIH HHS; R01 AG034676/AG/NIA NIH HHS

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