title: Bone mineral density in girls with forearm fractures.
abstract: In childhood, the most common site of fracture is the distal forearm. To determine whether young girls with these fractures have low bone density more commonly than fracture-free controls, we measured bone density at the radius, spine, hip, and whole body and total body bone mineral content, lean tissue mass, and fat mass by dual-energy X-ray absorptiometry in 100 Caucasian girls aged 3-15 years with recent distal forearm fractures and 100 age- and gender-matched controls. Bone density (age-adjusted ratios of all cases:controls with 95% confidence intervals) was lower in cases at the ultradistal radius 0.963 (0.930-0.996), 33% radius 0.972 (0.945-0.999), lumbar spine 0.945 (0.911-0.980), hip trochanter 0.952 (0.918-0.988), and total body 0.978 (0.961-0.995). Moreover, osteopenia (defined as Z score below -1), was more common in cases than controls (p < 0.05) in the forearm, spine, and hip, with one third of fracture cases having low spinal density. Odds ratios (95% confidence intervals) for low bone density were: ultradistal radius, 2.2 (1.1-4.6); lumbar spine, L2-L4, 2.6 (1.3-4.9); and femur trochanter, 2.0 (1.0-3.9). Fracture patients aged 8-10 years weighed more (mean +/- SD) than age-matched controls (37.2+/-8.0 kg vs. 32.5+/-6.6 kg, p < 0.01) while older patients reported lower current and past calcium intakes than matched controls (p < 0.05). We conclude that low bone density is more common throughout the skeleton in girls with forearm fractures than in those who have never broken a bone, supporting the view that low bone density may contribute to fracture risk in childhood.
authors.affiliation: Department of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: A
authors.initials: A
authors.lastname: Goulding
authors.forename: R
authors.initials: R
authors.lastname: Cannan
authors.forename: S M
authors.initials: SM
authors.lastname: Williams
authors.forename: E J
authors.initials: EJ
authors.lastname: Gold
authors.forename: R W
authors.initials: RW
authors.lastname: Taylor
authors.forename: N J
authors.initials: NJ
authors.lastname: Lewis-Barned
mesh_terms: D000293:Adolescent; D015519:Bone Density; D002648:Child; D002675:Child, Preschool; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000502:physiology; D006304:Health Status; D006801:Humans; D011627:Puberty; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000503:physiopathology; D011885:Radius Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014458:Ulna Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology*