Which fractures are associated with low appendicular bone mass in elderly women? The Study of Osteoporotic Fractures Research Group.
OBJECTIVE
To determine which types of fractures have an increased incidence in elderly women with low appendicular bone mass.


METHODS
Prospective cohort study.


METHODS
Four clinical centers in the United States (Baltimore, Maryland; Minneapolis, Minnesota; Portland, Oregon; Monangehela Valley, Pennsylvania); and one coordinating center in San Francisco, California.


METHODS
Ambulatory, nonblack women (9704) aged 65 years or more who were recruited from population-based listings.


METHODS
We measured bone mass at the distal and proximal radius and calcaneus using single-photon absorptiometry. Fractures were verified radiographically. Associations were calculated as age-adjusted hazard ratios (with 95% Cls) per standard deviation decrease in bone mass.


RESULTS
During a mean follow-up of 2.23 years, 841 nonspinal fractures occurred in 753 women. The risks for fractures of the wrist, foot, humerus, hip, rib, toe, leg, pelvis, hand, and clavicle were significantly related to reduced bone mass (P less than 0.05). These fractures represented 74% of nonspinal fractures. The overall hazard ratio for the occurrence of one or more of these fractures was 1.65 (Cl, 1.49 to 1.82) at the distal radius. In a subsample of the cohort, vertebral fractures were also related to low bone mass. Fractures of the ankle, elbow, finger, and face, however, were not associated with bone mass at any measurement site; the overall hazard ratio for these fractures was 1.12 (Cl, 0.96 to 1.30) at the distal radius.


CONCLUSIONS
Most types of fractures have an increased incidence in elderly women with low bone mass.
Seeley
D G
DG
University of California, San Francisco.
Browner
W S
WS
Nevitt
M C
MC
Genant
H K
HK
Scott
J C
JC
Cummings
S R
SR
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D002111:Calcaneus; D005260:Female; D050723:Fractures, Bone / Q000209:etiology*; D006620:Hip Fractures / Q000209:etiology; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000150:complications*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011884:Radius; D012307:Risk Factors; D016103:Spinal Fractures / Q000209:etiology