Contribution of in vivo structural measurements and load/strength ratios to the determination of forearm fracture risk in postmenopausal women.

Contribution of in vivo structural measurements and load/strength ratios to the determination of forearm fracture risk in postmenopausal women. Research Abstract Details 

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Contribution of in vivo structural measurements and load/strength ratios to the determination of forearm fracture risk in postmenopausal women. Abstract Text:

L Joseph Melton,B Lawrence Riggs,G Harry van Lenthe,Sara J Achenbach,Ralph ,Mary L Bouxsein,Shreyasee Amin,Elizabeth J Atkinson,Sundeep Khosla,

Bone structure, strength and load-strength ratios contribute to forearm fracture risk independently of areal BMD. INTRODUCTION: Technological and conceptual advances provide new opportunities for evaluating the contribution of bone density, structure, and strength to the pathogenesis of distal forearm fractures. MATERIALS AND METHODS: From an age-sratified random sample of Rochester, MN, women, we compared 18 with a distal forearm fracture (cases) to 18 age-matched women with no osteoporotic fracture (controls). High-resolution pQCT was used to assess volumetric BMD (vBMD), geometry, and microstructure at the ultradistal radius, the site of Colles' fractures. Failure loads in the radius were estimated from microfinite element (microFE) models derived from pQCT. Differences between case and control women were assessed, and the risk of fracture associated with each variable was estimated by logistic regression analysis. RESULTS: Given similar heights, estimated loading in a fall on the outstretched arm was the same in cases and control. However, women with forearm fractures had inferior vBMD, geometry, microstructure, and estimated bone strength. Relative risks for the strongest determinant of fracture in each of the five main variable categories were as follows: BMD (total vBMD: OR per SD change, 4.2; 95% CI, 1.4-12), geometry (cortical thickness: OR, 4.0; 95% CI, 1.4-11), microstructure (trabecular number: OR, 2.3; 95% CI, 1.02-5.1), and strength (axial rigidity: OR, 3.8; 95% CI, 1.4-10); the factor-of-risk (fall load/microFE failure load) was 24 % greater (worse) in cases (OR, 3.0; 95% CI, 1.2-7.5). Areas under ROC curves ranged from 0.72 to 0.82 for these parameters. CONCLUSIONS: Bone geometry, microstructure, and strength contribute to forearm fractures, as does BMD, and these additional determinants of risk promise greater insights into fracture pathogenesis.

Contribution of in vivo structural measurements and load/strength ratios to the determination of forearm fracture risk in postmenopausal women. Publishing Authors By Initials

LJ Melton,BL Riggs,GH van Lenthe,SJ Achenbach,R ,ML Bouxsein,S Amin,EJ Atkinson,S Khosla,

For similar disorders of environmental origin: wounds and injuries: arm injuries: forearm injuries: ulna fractures research abstracts see: disorders of environmental origin: wounds and injuries: arm injuries: forearm injuries: ulna fractures research

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Contribution of in vivo structural measurements and load/strength ratios to the determination of forearm fracture risk in postmenopausal women. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Journal of bone and mineral research : the officia

VOLUME: 22

Page Numbers: 1442-8

Journal Abbreviation: J. Bone Miner. Res.

ISSN: 0884-0431

DAY: 3

MONTH: Sep

YEAR: 2007

Contribution of in vivo structural measurements and load/strength ratios to the determination of forearm fracture risk in postmenopausal women. Information

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LANGUAGE: eng

NlmUniqueID: 8610640

Contribution of in vivo structural measurements and load/strength ratios to the determination of forearm fracture risk in postmenopausal women. Keywords Mesh Terms:

KEYWORDS: Ulna Fractures

MESH TERMS: pathology

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Grant and Affiliation Information for Contribution of in vivo structural measurements and load/strength ratios to the determination of forearm fracture risk in postmenopausal women.

AFFILIATION: Division of Epidemology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.

Country: United States

AGENCY: United States NIAMS

GRANT: R01-AR27065

ACRONYM: AR

MEDLINETA: J Bone Miner Res

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