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Osteoporosis International

Published in:

01-01-2017 | Original Article

Fractures in spina bifida from childhood to young adulthood

Authors: A. Trinh, P. Wong, J. Brown, S. Hennel, P. R. Ebeling, P. J. Fuller, F. Milat

Published in: Osteoporosis International | Issue 1/2017

Abstract

Summary

This study assessed the prevalence and types of fractures in spina bifida and examined risk factors for fracture. Fracture prevalence was highest in childhood and reduced in adolescence and young adulthood. The importance of maintaining mobility is highlighted by the increased risk of fracture in those who are non-ambulatory.

Introduction

The aims of this study are to study the prevalence and types of fractures according to age group in spina bifida and examine risk factors associated with fracture.

Methods

This is a retrospective cohort study of 146 individuals with spina bifida aged 2 years or older who attended the paediatric or adult spina bifida multidisciplinary clinic at a single tertiary hospital.

Results

Median age at which first fracture occurred was 7 years (interquartile range 4–13 years). Fracture rates in children (ages 2–10), adolescents (ages 11–18) and adults (age > 18) were 10.9/1000 (95 % confidence interval 5.9–18.3), 5.4/1000 (95 % CI 1.5–13.8) and 2.9/1000 (95 % CI 0.6–8.1) patient years respectively. Childhood fractures predominantly involved the distal femur and femoral shaft; these fractures were rarely seen in adulthood. Non-ambulatory status was associated with a 9.8 times higher risk of fracture compared with ambulatory patients (odds ratio 9.8, p = 0.016, 95 % CI 1.5–63.0). Relative risk of re-fracture was 3.1 (95 % CI 1.4–6.8). Urological intervention with intestinal segments was associated with renal calculi (p = 0.037) but neither was associated with fracture.

Conclusions

The risk of fracture is lower in adults compared with children with spina bifida. The predominant childhood fracture affects the distal femur, and immobility is the most significant risk factor for fracture. Clinical factors contributing to fracture risk need to be elucidated to enable selection of patients who require investigation and treatment of osteoporosis.

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Title: Fractures in spina bifida from childhood to young adulthood
Authors: A. Trinh
P. Wong
J. Brown
S. Hennel
P. R. Ebeling
P. J. Fuller
F. Milat
Publication date: 01-01-2017
Publisher: Springer London
Published in: Osteoporosis International / Issue 1/2017
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-016-3742-0

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Fractures in spina bifida from childhood to young adulthood

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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