title: Fracture prevalence in Duchenne muscular dystrophy.
abstract: The objective of this study was to determine the prevalence, circumstances, and outcome of fractures in males with Duchenne muscular dystrophy (DMD) attending neuromuscular clinics. Three hundred and seventy-eight males (median age 12 years, range 1 to 25 years) attending four neuromuscular centres were studied by case-note review supplemented by GP letter or by interview at the time of clinic attendance. Seventy-nine (20.9%) of these patients had experienced fractures. Forty-one percent of fractures were in patients aged 8 to 11 years and 48% in independently ambulant patients. Falling was the most common mechanism of fracture. Upper-limb fractures were most common in males using knee-ankle-foot orthoses (65%) while lower-limb fractures predominated in independently mobile and wheelchair dependent males (54% and 68% respectively). Twenty percent of ambulant males and 27% of those using orthoses lost mobility permanently as a result of the fracture. In a substantial proportion of males, the occurrence of a fracture had a significant impact on subsequent mobility.
authors.affiliation: Oxford Radcliffe NHS Trust, UK.
authors.forename: Denise G M
authors.initials: DG
authors.lastname: McDonald
authors.forename: Maria
authors.initials: M
authors.lastname: Kinali
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Gallagher
authors.forename: Eugenio
authors.initials: E
authors.lastname: Mercuri
authors.forename: Francesco
authors.initials: F
authors.lastname: Muntoni
authors.forename: Helen
authors.initials: H
authors.lastname: Roper
authors.forename: Philip
authors.initials: P
authors.lastname: Jardine
authors.forename: David Hilton
authors.initials: DH
authors.lastname: Jones
authors.forename: M G
authors.initials: MG
authors.lastname: Pike
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology / Q000534:rehabilitation; D006801:Humans; D007223:Infant; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000150:complications / Q000453:epidemiology* / Q000534:rehabilitation; D009989:Orthotic Devices; D012307:Risk Factors; D014910:Wheelchairs