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Two Distinct Etiologies for Distal Forearm Fractures in Childhood

Skeletal deficits lead to fracture with mild trauma; significant trauma causes fx with normal bone
THURSDAY, Jan. 16, 2014 (HealthDay News) -- Childhood distal forearm fractures (DFFs) have two distinct etiologies, according to a study published in the Journal of Bone and Mineral Research.
Joshua N. Farr, Ph.D., from the Mayo Clinic in Rochester, Minn., and colleagues examined bone strength and cortical and trabecular bone macro- and microstructure at the distal radius and tibia in a cohort of 115 boys and girls with recent DFF and 108 non-fracture controls aged 8 to 15 years.
The researchers found that boys and girls with a mild trauma DFF (e.g., fall from standing height) showed significant deficits at the distal radius in failure load and had worse fall load-to-strength ratios, compared with sex-matched controls. There were also significant reductions in cortical area and thickness in boys and girls with a mild trauma DFF versus controls. For children with mild trauma DFF, the skeletal deficits were generalized, with similar changes seen at the distal tibia. For boys and girls with a moderate trauma DFF (e.g., fall from a bicycle), the values for all of the measured bone parameters were virtually identical to those of controls.
"In conclusion, DFFs during growth have two distinct etiologies: those due to underlying skeletal deficits leading to fractures with mild trauma versus those due to more significant trauma in the setting of normal bone strength," the authors write.
Abstract (http://onlinelibrary.wiley.com/doi/10.1002/jbmr.2071/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/jbmr.2071/pdf )
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