Fractures of the Femoral Shaft in Children. Incidence, Mechanisms, and Sociodemographic Risk Factors*

Hinton, Richard Y.; Lincoln, Andrew E.; Crockett, Michele M.; Sponseller, Paul D.; Smith, Gordon S.

doi:10.2106/00004623-199904000-00007

Cited by 182 publications

(166 citation statements)

References 24 publications

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“…To our knowledge, this is the first study in which the association between lower BMD and increased odds of forearm fracture risk has been shown in African American children, a pediatric population that may be at higher risk for bone health deficiencies and fractures. [24][25][26]32,33 Our results add to the growing body of literature, which previously has shown a difference in BMD between generally healthy and largely white children with and without forearm fractures. [12][13][14][15][16] Similarly, this is the first study in which vitamin D deficiency has been associated with increased odds of forearm fracture in any pediatric population.…”

Section: Discussionsupporting

confidence: 62%

“…Although the prevalence of osteoporosis and related fragility fracture is lower in African American women compared with white women, osteoporosis is not uncommon in the African American adult population 70,71 and may be underdiagnosed. 72 Additional study is needed to better understand and improve bone health in the African American population given our study findings of an increased prevalence of factors associated with forearm fracture risk, [24][25][26][27][28][29][30] higher rates of some fractures, 32,33 and the apparent paradox of a relatively increased BMD in comparison with white children. 31 …”

Section: Discussionmentioning

confidence: 99%

“…30 Although African American children have a relatively increased BMD in comparison with white children and studies of a South African cohort show higher fracture rates in white children, other studies show a higher incidence of femur fracture and fracture-related hospitalizations in African American children. [31][32][33][34][35] Incidence of childhood forearm fracture, by race, has not been reported.…”

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confidence: 99%

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Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

2012

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Forearm fractures are unique injuries which are associated with lower bone mineral density in adults and white children. The relationships among bone mineral density, 25-hydroxyvitamin D status, and risk for forearm fracture have not been investigated in African American children. WHAT THIS STUDY ADDS:Our data support an association between both lower bone mineral density and vitamin D deficiency and increased odds of forearm fracture in African American children. Promotion of bone health is indicated in this population.abstract OBJECTIVE: To determine whether African American children with forearm fractures have decreased bone mineral density and an increased prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D level #20 ng/mL) compared with fracture-free control patients. METHODS:This case-control study in African American children, aged 5 to 9 years, included case patients with forearm fracture and control patients without fracture. Evaluation included measurement of bone mineral density and serum 25-hydroxyvitamin D level. Univariable and multivariable analyses were used to test for associations between fracture status and 2 measures of bone health (bone mineral density and 25-hydroxyvitamin D level) while controlling for other potential confounders. RESULTS:The final sample included 76 case and 74 control patients. There were no significant differences between case and control patients in age, gender, parental education level, enrollment season, outdoor play time, height, or mean dietary calcium nutrient density. Cases were more likely than control patients to be overweight (49.3% vs 31.4%, P = .03). Compared with control patients, case patients had lower whole body z scores for bone mineral density (0.62 6 0.96 vs 0.98 6 1.09; adjusted odds ratio 0.38 [0.20-0.72]) and were more likely to be vitamin D deficient (47.1% vs 40.8%; adjusted odds ratio 3.46 [1.09-10.94]). CONCLUSIONS:These data support an association of lower bone mineral density and vitamin D deficiency with increased odds of forearm fracture among African American children. Because suboptimal childhood bone health also negatively impacts adult bone health, interventions to increase bone mineral density and correct vitamin D deficiency are indicated in this population to provide short-term and long-term benefits. Pediatrics 2012;130:e553-e560

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

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Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

2012

PEDIATRICS

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“…These injuries are usually isolated injuries and in a majority of the cases, shaft of the femur is involved [1] . The most common cause for this type of injury in the paediatric population is a fall or a motor vehicle accident [2,3,4] . Although any reasonable form of treatment for fracture shaft femur gives satisfactory outcome yet the orthopedic surgeons remain divided over the optimal method of treating femoral fractures in children.…”

Section: Introductionmentioning

confidence: 99%

Flexible Intramedullary Nail Fixation in Paediatric Femoral Shaft Fractures

Jadaan

Jain

Khayyat

2016

International Journal of Orthopaedics

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“…Femoral diaphysis fractures are caused by highenergy trauma and are among the commonest pediatric traumatic lesions treated by orthopedic surgeons (1)(2)(3) . In children and adolescents, these fractures present bimodal distribution, with peaks at between two and three years of age (5.9/10,000/ year) and at 17-18 years (4.2/10,000/year) (4) .…”

Section: Introductionmentioning

confidence: 99%

Fraturas instáveis do fêmur em crianças tratadas com hastes intramedulares elásticas de titânio

et al. 2012

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ABSTRACTdiaphysis fractures treated with elastic titanium intramedullary nails with retrograde insertion were included in the study. There were two bilateral fractures and two exposed fractures. Seven patients were female and 17 were male, and the mean age was 8.3 years. The following were presented at the end of the study: shortening, varus or valgus displacement, final retrocurvatum or antecurvatum of zero, and absence of delayed consolidation or pseudarthrosis. Conclusions: The elastic titanium intramedullary nails were easily placed and removed. We believe that using elastic titanium intramedullary nails is a good option for fixation of unstable femoral fractures in children.

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Fractures of the Femoral Shaft in Children. Incidence, Mechanisms, and Sociodemographic Risk Factors*

Cited by 182 publications

References 24 publications

Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

Flexible Intramedullary Nail Fixation in Paediatric Femoral Shaft Fractures

Fraturas instáveis do fêmur em crianças tratadas com hastes intramedulares elásticas de titânio

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