title: Non-hip and non-vertebral fractures: the neglected fracture sites.
abstract: CONCLUSIONS
  Non-hip, non-vertebral fractures (NHNVF) were compared with hip, vertebral and controls. NHNVF were younger and heavier than controls and hip/vertebral fractures in both men and women, respectively. Falls and prior fractures were less common in NHNVF than hip fractures. Glucocorticoid use was lower in NHNVF compared to vertebral fracture (VF) in men.
  
  
  BACKGROUND
  Although hip fracture (HF) and vertebral fractures (VF) receive the most attention in the literature and are the targeted sites for fracture prevention, non-hip, non-vertebral fracture (NHNVF) sites account for a greater proportion of fractures than the hip or vertebrae. This study aimed to assess risk factors for NHNVF and compare them with those for HF, VF and controls.
  
  
  METHODS
  Incident fractures during 2005-2007 for men and 1994-1996 for women were identified using computerised keyword searches of radiological reports, and controls were selected at random from electoral rolls for participation in the Geelong Osteoporosis Study. Participants aged 60+ years were included in this study.
  
  
  RESULTS
  Compared to controls, men and women with NHNVF were younger (ORs, 0.90, 95% CI 0.86-0.94; and 0.96, 0.93-0.98, respectively) and had a lower femoral neck bone mineral density (BMD) T-score (age-adjusted; difference [men] 0.383, P = 0.002; [women] 0.287, P = 0.001). Compared to HF, men and women with NHNVF were heavier (difference [men] 9.0 kg, P = 0.01; [women] 7.6 kg, P < 0.001). Heavier weight was also a risk factor for women with NHNVF compared to VF (1.03, 1.01-1.06). In men with NHNVF, falls (0.37, 0.14-0.97) and prior fractures (0.38, 0.15-0.98) were less common compared to HF; and glucocorticoid use was less common for NHNVF (0.30, 0.11-0.85) compared to VF.
  
  
  CONCLUSIONS
  Given the high numbers of NHNVF sustained by men and women in this study, fracture prevention strategies should focus on individuals with high risk of sustaining these types of fractures, as well as on individuals who are more likely to sustain a HF or VF.
authors.affiliation: Epi-Centre for Healthy Ageing (ECHA), IMPACT Strategic Research Centre, Kitchener House (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia. khollo@barwonhealth.org.au.
authors.forename: K L
authors.initials: KL
authors.lastname: Holloway
authors.affiliation: Barwon Health, Ryrie Street, Geelong, VIC, Australia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Henry
authors.affiliation: Epi-Centre for Healthy Ageing (ECHA), IMPACT Strategic Research Centre, Kitchener House (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.|The Institute for Health and Ageing, Australian Catholic University, Melbourne, VIC, Australia.|Department of Medicine, The University of Melbourne, St Albans, VIC, Australia.|Australian Institute for Musculoskeletal Science, The University of Melbourne, 176 Furlong Rd, St Albans, VIC, Australia.
authors.forename: S L
authors.initials: SL
authors.lastname: Brennan-Olsen
authors.affiliation: Epi-Centre for Healthy Ageing (ECHA), IMPACT Strategic Research Centre, Kitchener House (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Bucki-Smith
authors.affiliation: The Institute for Health and Ageing, Australian Catholic University, Melbourne, VIC, Australia.|Rural Clinical School, The University of Queensland, Toowoomba, QLD, Australia.
authors.forename: G C
authors.initials: GC
authors.lastname: Nicholson
authors.affiliation: Barwon Health, Ryrie Street, Geelong, VIC, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Korn
authors.affiliation: The Institute for Health and Ageing, Australian Catholic University, Melbourne, VIC, Australia.|Department of Medicine, The University of Melbourne, St Albans, VIC, Australia.|Australian Institute for Musculoskeletal Science, The University of Melbourne, 176 Furlong Rd, St Albans, VIC, Australia.
authors.forename: K M
authors.initials: KM
authors.lastname: Sanders
authors.affiliation: Epi-Centre for Healthy Ageing (ECHA), IMPACT Strategic Research Centre, Kitchener House (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.|Barwon Health, Ryrie Street, Geelong, VIC, Australia.|Department of Medicine, The University of Melbourne, St Albans, VIC, Australia.
authors.forename: J A
authors.initials: JA
authors.lastname: Pasco
authors.affiliation: Epi-Centre for Healthy Ageing (ECHA), IMPACT Strategic Research Centre, Kitchener House (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.|Barwon Health, Ryrie Street, Geelong, VIC, Australia.|Department of Medicine, The University of Melbourne, St Albans, VIC, Australia.
authors.forename: M A
authors.initials: MA
authors.lastname: Kotowicz
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight / Q000502:physiology; D015519:Bone Density / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D005938:Glucocorticoids / Q000009:adverse effects; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D012737:Sex Factors; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D014739:Victoria / Q000453:epidemiology
chemical_list: D005938:Glucocorticoids
keywords: Elderly; Fractures; Non-hip; Non-vertebral fractures; Risk factors