Osteoporosis in men with a history of tibial fracture

Abstract

The long-term effects of bone fractures on bone mineral density (BMD) at various skeletal sites are poorly established, although a serious fracture, such as a tibia fracture, followed by long immobility and disuse may lead to permanently decreased BMD and, through this mechanism, may be a risk factor for osteoporotic fractures in later life. To determine whether such an injury leads to osteoporosis, we measured the areal BMD (g/cm2) from the lumbar spine (L2-4), right distal radius and ulna, and the femoral neck, distal femur, patella, proximal tibia, distal tibia, and calcaneus of both extremities in 14 men with a history of primarily nonunited (finally bone-grafted) shaft fracture of the tibia and 20 men with a history of primary union. For evaluation of the patients' BMD in the spine and distal forearm, 22 age-, weight-, and height-matched normal men were also measured. The average time of immobilization in a long plaster cast was 27 weeks in the former group of patients and 16 weeks in the latter. The measurements were performed an average of 9 years after the fracture using a dual-energy x-ray absorptiometric scanner. Compared with normal men (mean +/- SD = 1.116 +/- 0.160), the spinal BMDs were significantly lower in men with a history of a primary nonunion (0.979 +/- 0.100, -12.3%) and union (1.010 +/- 0.124, -9.5%). In distal radius and distal ulna, there were no significant differences between the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)