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Risk factors for upper limb fractures in children

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Ma, Deqiong (2004) Risk factors for upper limb fractures in children. PhD thesis, University of Tasmania.

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Abstract

Fractures in younger life are very common especially those involving the upper limb.
However, the causes of these fractures are poorly understood. The aim of this population
based case-control study was to evaluate the association of both bone dependent and
independent factors with upper limb fracture risk in children 9-16 years of age. Areal
(aBMD) and apparent (BMAD) bone mineral density were measured by dual energy Xray
absorptiometry (DXA). Skeletal age (SA) and metacarpal index (MI) was determined
by hand radiograph. Types and patterns of physical activity, risk taking and diet were
assessed by interview-administered questionnaires. Coordination was measured using the
8-point movement ABC. A total of 321 fracture cases and 321 randomly selected ageand
gender- matched controls were recruited. Fracture sites were as follow: hand: n=91,
wrist and forearm: n=190, upper arm: n=40. Conditional logistic regression analysis
showed wrist and forearm fracture risk was significantly associated with lumbar spine
BMAD (OR: 1.52/SD reduction, 95% CI 1.18-1.96), MI (OR: 1.43/SD reduction, 95% CI
1.14-2.20), light physical activity (OR: 0.81/unit, 95% CI 0.65-1.00), cola consumption
(OR: 1.43/category, 95% CI 1.08-1.88) but conclusions may be limited by sample size
considerations. Obesity or overweight was not associated with any fracture type. For total
fractures, there was a gender discordant effect of sports participation with an increased
fracture risk in boys and decreased fracture risk in girls which reached statistical
significance for total, contact, non-contact and high-risk sports participation as well as
four individual sports (soccer, cricket, surfing and swimming). In conclusion, both bone
dependent and independent factors are important determinants of upper limb fracture risk
in children. There is heterogeneity of cause for both gender and different fracture sites
that will necessitate different approaches to prevention.

Item Type: Thesis (PhD)
Keywords: Fractures in children
Copyright Holders: The Author
Copyright Information:

Copyright 2004 the Author - The University is continuing to endeavour to trace the copyright
owner(s) and in the meantime this item has been reproduced here in good faith. We
would be pleased to hear from the copyright owner(s).

Additional Information:

For consultation only. No copying permitted until 16 April 2006. Thesis (Ph.D.)--University of Tasmania, 2004. Includes bibliographical references

Date Deposited: 19 Dec 2014 02:46
Last Modified: 21 Jul 2017 05:36
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