Metacarpal Indices and Their Association with Fracture in South African Children and Adolescents

Calcified Tissue International
A MaganJohn M Pettifor

Abstract

This prospective study assessed whether metacarpal indices predict fracture risk in children and adolescents. Radiogrammetry was performed at the second metacarpal midshaft on annual hand-wrist radiographs of 359 South African (SA) children aged 10-17 years. Bone length, bone width, and medullary width were measured, and the following proxies for bone strength calculated: metacarpal index (MCI), bone mineral density (BMD), section modulus (SM), stress-strain index (SSI), and slenderness index (SLI). Height and weight were measured annually. Self-reported physical activity (PA) and fracture history were obtained at ages 15 years (for the preceding 12 months) and 17 years, respectively. At 17 years, 82 (23%) participants (black, 16%; white, 42%; p < 0.001) reported a previous fracture. None of the bone measures or indices were associated with fracture in black participants. In white females, after adjusting for PA, a 1 standard deviation (SD) greater SLI doubled the fracture risk [odds ratio (OR) 2.08; 95% confidence interval (CI) 1.08, 3.98]. In white males, a 1 SD greater BMD was associated with a 2.62-fold increase in fracture risk (OR 3.62; 95% CI 1.22, 10.75), whilst a 1 SD greater SM (OR 2.29; 95% CI 1.07, 4.89) and SSI (OR...Continue Reading

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Citations

Oct 30, 2019·Hand : Official Journal of the American Association for Hand Surgery·Andrew SephienFrancisco A Schwartz-Fernandes
Feb 14, 2021·American Journal of Physical Anthropology·Rebecca J GilmourTracy L Prowse
Nov 3, 2020·Pediatric Radiology·Amaka C Offiah, Christine M Hall

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