medigraphic.com
ISSN 2992-779X (Electronic)
ISSN 2007-6452 (Print)

2014, Number 4

<< Back Next >>

Investigación en Discapacidad 2014; 3 (4)

Bone mineral density, nutritional condition and fractures of long bones in children

Redon-Tavera A, Rodríguez-Madrid R, León-Hernández SR, Díez-García P, Becerra-Luna L

Language: Spanish
References: 16
Page: 168-176
PDF size: 166.33 Kb.


ABSTRACT

A transverse cohort study was conducted in 66 children, 43 male and 23 female, aged 2.0 to 14.5 years, who were consecutively admitted from March through July 2009 because of long-bones fracture, to correlate the amount of energy (AOE) required to produce the fracture compared to bone mineral density (BMD, by Z-Score) and the nutritional condition (NC) of patients. Fractures were 34 supracondylar humeral (51.5%), radio-ulnar 19 (28.8%), femur shaft-distal 5 (7.6%) and tibia-ankle 8 (12.1%). Results demonstrated a parallel correlationship between the higher age and higher energy required for a fracture (p = 0.001). As well, BMD was higher as patients grew-up in age (Spearman p = 0.0001). No true relationship was found between AOE and the NC, as most children (81.8%) addressed a normal body weight. In spite of a tendency to decrease BMD in the 6.1% of the obese children, figures were not significantly different to those with normal body weight (KW p = 0.70). When matching trauma energy to observed BMD, this was lower than expected in mild or low energy fractures. Values of observed BMD and expected BMD values were obtained by regression test. Global results demonstrated a straight correlationship among cases of tibial-ankle fractures and a higher energy required for a fracture in older children (ages 12 to 14 years) in whom observed BMD was somewhat higher than expected BMD.


REFERENCES

  1. Raush F, Schoenau E. Skeletal development in premature infants: a review of bone physiology beyond nutritional aspects. Arch Dis Child Fetal Neonatal. 2006; 21 (9): 1489-1495.

  2. Clark EM, Ness AR, Bishop NJ, Tobias JH. Association between bone mass and fractures in children: a prospective cohort study. J Bone Miner Res. 2006; 21 (9): 1489-1495.

  3. Clark EM, Ness AR, Tobias JH. Bone fragility contributes to the risk of fracture in children, even after moderate and severe trauma. J Bone Mineral Res. 2008; 23 (2): 173-179.

  4. Goulding A, Cannan R, Williams SR, Gold EJ, Taylor RW, Louis-Barned NJ. Bone mineral density in girls with forearm fractures. J Bone Miner Res. 1998; 13 (1): 143-148.

  5. Goulding A, Rockell JEP, Black RE, Grant AM, Jones IA, Williams SL. Children who avoid drinking cow’s milk are at increased risk for prepuberal bone fractures. J Am Diet Assoc. 2004; 104 (2): 250-253.

  6. Black RE, Williams SW, Jones IE. Children who avoid drinking cow milk have low dietary calcium intakes and poor bone health. Am J Clin Nutr. 2002; 76: 675-680.

  7. Martínez MR. Salud y enfermedad del niño y del adolescente. 6a ed. México: El Manual Moderno; 2009: pp. 1765-1808.

  8. Warner JT, Cowan FJ, Dunstan FD, Evans WD, Webb DK, Gregory JW. Measured and predicted bone mineral content in healthy boys and girls aged 6-18 years: adjusted for body size and puberty. Acta Pediatr. 1998; 878: 244-249.

  9. Khoury DJ, Szalay EA. Bone mineral correlation with fractures in nonambulatory pediatric patients. J Pediat Orthop. 2007; 27 (5): 562-566.

  10. Southard RN, Morris JD, Mahan JD. Bone mass in healthy children: measurement with quantitative DXA. Radiology. 1991; 179 (3): 735-738.

  11. De Schepper J, Derde MP, Van den Broeck M, Piepsz A, Jonckheer MH. Normative data for lumbar spine bone mineral content in children: influence of age, height, weight, and pubertal stage. J Nucl Med. 1991; 32 (2): 216-220.

  12. Stark AD, Bennet GC, Stone DH, Christi P. Association between childhood fractures and poverty: population based study. British Med J. 2002; 324: 457.

  13. Lee WT, Leung SS, Wang SH, Xu YC, Zeng WP, Lau J et al. Double-blind controlled calcium supplementation and bone mineral accretion in children accustomed to a low calcium diet. Am J Clin Nutrition. 1994; 60: 744-750.

  14. Zhu K, Zhang Q, Foo LH, Trube A, Ma G, Hu X et al. Growth, bone mass, and vitamin D status of Chinese adolescent girls after withdrawal of milk supplementation. Am J Clin Nutrition. 2006; 83: 714-721.

  15. Henderson RC, Lark RK, Gurka MJ, Worley G, Fung EB, Conway M et al. Bone density and metabolism in children and adolescents with moderate to severe cerebral palsy. Pediatrics. 2002; 110: e5.

  16. Estrada A, Ramnitz SM, Gafni RI. Bone densitometry in children and adolescents. Curr Opinion Obstet Gunecol. 2014; 26 (5): 339-346.




2020     |     www.medigraphic.com