title: A historical study of appendicular fractures in veterans with traumatic chronic spinal cord injury: 2002-2007.
abstract: Describe the incidence and distribution of appendicular fractures in a cohort of veterans with spinal cord injury (SCI).
  
  
  
  Retrospective, observational study of fractures in veterans with a chronic traumatic SCI.
  
  
  
  The Veterans Health Administration (VA) healthcare system.
  
  
  
  Veterans included in the VA Spinal Cord Dysfunction Registry from Fiscal Years (FY) FY2002-FY2007.
  
  
  
  Not applicable.
  
  
  
  Description of fractures by site and number. Mortality at one year following incident fracture among men with single vs. multiple fractures.
  
  
  
  Male and female veterans sustained incident fractures with similar observed frequency (10.5% vs 11.5%). The majority of fractures occurred in the lower extremities for both men and women. In men, a complete extent of injury (compared to incomplete) was associated with 41% greater relative risk (RR) of incident fracture (RR 1.41, 95% confidence interval [1.17, 1.70]) among those with tetraplegia, but not paraplegia. Furthermore, many men (33.9%, n = 434) sustained multiple fractures over the course of the study. There were no differences in mortality between men who sustained a single fracture and those who had multiple fractures.
  
  
  
  The extent of injury may be an important predictor of fracture risk for male veterans with tetraplegia. Once a fracture occurs, male veterans with SCI appear to be at high risk for additional fractures.
authors.affiliation: a Subspecialty Service, Department of Veterans Affairs Medical Center , Augusta , GA , USA.|b Department of Medicine , Georgia Regents University , Augusta , GA , USA.
authors.forename: Monique
authors.initials: M
authors.lastname: Bethel
authors.affiliation: c Center of Innovation for Complex Chronic Healthcare , Edward J. Hines, Jr. VA Hospital , Hines , IL , USA.|d Department of Epidemiology and Biostatistics, School of Public Health , University of Illinois at Chicago , Chicago , IL , USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Bailey
authors.affiliation: c Center of Innovation for Complex Chronic Healthcare , Edward J. Hines, Jr. VA Hospital , Hines , IL , USA.|e Stritch School of Medicine , Loyola University , Maywood , IL , USA.
authors.forename: Frances
authors.initials: F
authors.lastname: Weaver
authors.affiliation: a Subspecialty Service, Department of Veterans Affairs Medical Center , Augusta , GA , USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Harmon
authors.affiliation: a Subspecialty Service, Department of Veterans Affairs Medical Center , Augusta , GA , USA.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Priebe
authors.affiliation: a Subspecialty Service, Department of Veterans Affairs Medical Center , Augusta , GA , USA.|b Department of Medicine , Georgia Regents University , Augusta , GA , USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Le
authors.affiliation: a Subspecialty Service, Department of Veterans Affairs Medical Center , Augusta , GA , USA.|b Department of Medicine , Georgia Regents University , Augusta , GA , USA.
authors.forename: Hammad
authors.initials: H
authors.lastname: Aslam
authors.affiliation: a Subspecialty Service, Department of Veterans Affairs Medical Center , Augusta , GA , USA.|b Department of Medicine , Georgia Regents University , Augusta , GA , USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Fausel
authors.affiliation: f Durham VA Medical Center , Durham , NC , USA.
authors.forename: Helen
authors.initials: H
authors.lastname: Hoenig
authors.affiliation: a Subspecialty Service, Department of Veterans Affairs Medical Center , Augusta , GA , USA.|b Department of Medicine , Georgia Regents University , Augusta , GA , USA.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Carbone
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000453:epidemiology*
keywords: Bone fractures; Epidemiology; Osteoporosis; Spinal cord injuries