The Relationship Between Fractures and DXA Measures of BMD in the Distal Femur of Children and Adolescents With Cerebral Palsy or Muscular Dystrophy
2010

Fractures and Bone Density in Children with Cerebral Palsy or Muscular Dystrophy

Sample size: 619 publication Evidence: high

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)

10.1359/jbmr.091007

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