Bone density and other possible predictors of fracture risk in children and adolescents with spastic quadriplegia

Developmental Medicine and Child Neurology
R C Henderson

Abstract

Forty-three patients with spastic quadriplegia (mean age 7.9 years, range 3.3 to 17.2 years) underwent bone mineral density (BMD) measurement of the lumbar spine and were evaluated between 2.6 and 5.5 years (mean 3.8) later to determine whether this measurement had predicted risk of fracture over the subsequent period of observation. Other potential risk factors that were evaluated include body weight z score, serum vitamin D levels, previous fracture, and hip spica casting. The baseline measurements showed that BMD falls further below normal with increasing age and was more than one standard deviation below age-matched normal mean in 38 of the 43 patients. Fracture rate did not differ between those with low and those with very low spinal BMD. Similarly, serum vitamin D levels and body weight z scores were not predictive of fracture. However, fracture rate was over fourfold greater following spica casting and more than threefold greater following an initial fracture. Fracture rates in the study group were similar to those reported for age- and sex-matched normal children, though generally the location of the fractures and mechanisms of injury differed.

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Citations

Jun 4, 2004·Developmental Medicine and Child Neurology·Richard C HendersonRichard D Stevenson
Apr 16, 2005·Journal of Pediatric Orthopedics·Maurice G SholasDeborah Gaebler-Spira
Jun 23, 2007·Journal of Pediatric Orthopedics·David J Khoury, Elizabeth A Szalay
Aug 28, 2009·Developmental Medicine and Child Neurology·Päivi Kilpinen-LoisaOuti Mäkitie
Jul 21, 2009·Developmental Medicine and Child Neurology·Sandra MerglerCorine Penning
Nov 3, 2010·Developmental Medicine and Child Neurology·Chia-Ling ChenAlice May-Kuen Wong
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