Abstract
Aim: To study fracture rates and risk factors for fractures in patients with spinal cord injuries. Material and methods: A self-administered questionnaire was mailed to 646 members of the Danish Paraplegic Association and 1000 randomly selected normal controls. 438 patients (309 males, 129 females, 67.8%) and 654 controls (332 males, 322 females, 65.4%) returned the questionnaire. Median age in patients was 42, range 10–80 years, and in controls 43, range 19–93 years (2p=0.25). Results: The crude fracture rate was 2% per year in patients and 1% per year in controls (RR=2.0, P<0.001). Low-energy fractures were much more prominent in patients (19.0% of all fractures) than in controls (1.4%, P<0.001). The fracture rate did not differ before the injury but increased after the injury to a constant level from the third year and forward. Fractures of the lower extremities were more prominent in patients than controls (femurs: RR=23.4, P<0.001, lower legs: RR=5.2, P<0.001, feet/toes: RR=2.4, P=0.006) while fractures of the forearms (P<0.001) and clavicles (P=0.03) were absent among patients. Fractures were more frequent in female patients (RR=1.6, P=0.008) and in male patients with a family history of fractures (RR=2.0, P=0.004). Conclusions: Low-energy fractures especially of the lower extremities are frequent in spinal cord injury patients and especially among female patients. The forearms seem protected from fractures.
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Vestergaard, P., Krogh, K., Rejnmark, L. et al. Fracture rates and risk factors for fractures in patients with spinal cord injury. Spinal Cord 36, 790–796 (1998). https://doi.org/10.1038/sj.sc.3100648
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DOI: https://doi.org/10.1038/sj.sc.3100648
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