title: Fractures in proximal spinal muscular atrophy.
abstract: BACKGROUND
  Fractures are a common problem for patients with spinal muscular atrophy (SMA).
  
  
  METHODS
  A total of 131 patients with proximal SMA with an average age of 13.2 +/- 9.2 years (0.7-65.6) were evaluated retrospectively. In 60 patients 94 different fractures were observed. The group consisted of 11 patients with type Ib, 81 with type II, 33 with type IIIa, 4 with IIIb and 2 with type IV. 38 of 81 SMA II patients and 17 of 33 SMA IIIa patients had suffered fractures at an average age of 8.3 +/- 5.3 years (0.0-25.1) (SMA II) and 9.3 +/- 6.0 years (0.0-22.1) (SMA IIIa).
  
  
  RESULTS
  The most frequent fractures were of the femur (50), usually distal, of the lower leg and ankle (15), and upper arm (9). The distribution of fractures was different in SMA II and SMA IIIa. Most of the fractures could be treated conservatively. Only two femoral shaft fractures, one upper arm and a lower arm fracture were treated surgically by osteosynthesis.
  
  
  CONCLUSIONS
  Competent fracture treatment is an important part of the orthopaedic care of SMA patients.
authors.affiliation: Department of Orthopaedic Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany. A.Fujak@t-online.de
authors.forename: Albert
authors.initials: A
authors.lastname: Fujak
authors.forename: Carsten
authors.initials: C
authors.lastname: Kopschina
authors.forename: Raimund
authors.initials: R
authors.lastname: Forst
authors.forename: Florian
authors.initials: F
authors.lastname: Gras
authors.forename: Lutz Arne
authors.initials: LA
authors.lastname: Mueller
authors.forename: Jürgen
authors.initials: J
authors.lastname: Forst
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001134:Arm Injuries / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005264:Femoral Fractures / Q000209:etiology*; D006801:Humans; D007223:Infant; D007869:Leg Injuries / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009134:Muscular Atrophy, Spinal / Q000150:complications* / Q000175:diagnosis; D012189:Retrospective Studies; D014897:Spinal Muscular Atrophies of Childhood / Q000150:complications; D055815:Young Adult