Fractures and Bone Density in Children with Cerebral Palsy or Muscular Dystrophy
Author Information
Author(s): Henderson Richard C, Berglund Lisa M, May Ryan, Zemel Babette S, Grossberg Richard I, Johnson Julie, Plotkin Horacio, Stevenson Richard D, Szalay Elizabeth, Wong Brenda, Kecskemethy Heidi H, Harcke H Theodore
Primary Institution: University of North Carolina
Hypothesis
The new measures of BMD in the distal femur correlate with fractures in children with limited or no ability to ambulate.
Conclusion
There is a strong correlation between fracture history and BMD Z-scores in the distal femur of children with disabilities.
Supporting Evidence
- 35% to 42% of those with BMD Z-scores less than −5 had fractured.
- 13% to 15% of those with BMD Z-scores greater than −1 had fractured.
- Risk ratios were 1.06 to 1.15 for each 1.0 decrease in BMD Z-score.
Takeaway
Kids who can't walk well often break bones more easily, and measuring their bone density in the thigh can help doctors understand this risk better.
Methodology
A cross-sectional study assessing the relationship between distal femur BMD Z-scores and fracture history in children aged 6 to 18 years with muscular dystrophy or cerebral palsy.
Potential Biases
Potential for overreporting or underreporting of fractures due to reliance on self-report.
Limitations
Fracture history was sometimes based on self-report and not consistently confirmed by medical records.
Participant Demographics
The study group had a mean age of 11.8 years, was 78% white, 15% black, and 46% of CP subjects were female.
Statistical Information
P-Value
p<0.0001
Confidence Interval
95% confidence interval 1.04–1.22
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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