Low bone mineral density and other risk factors in prepubertal children with fracture of the distal forearm

Aim: To investigate the relationship between bone mineral density (BMD), age, sex, anthropometric measurements, dietary calcium intake and daily physical activity, in prepubertal children with distal forearm fracture (DFF). Methods: 160 children (80 mates, 80 females) 3-10 years of age with DFF; control group of 160 children (age-sex matched) were studied. Age, sex, weight, height, tricipital skin fold thickness (TS), body mass index, daily calcium intake, and level of physical activity (extra-school physical exercise: tow < 1 hour/day, high > 1 hour/day) registered. BMD assessed by peripheral DXA densitometer. Results: Most fractures were caused by mild-moderate precipitating trauma by accidental fall (85.6%), with radius fracture in most cases (87.5%). BMI was higher in patients (19.14 kg/m(2)+/- 3.50 vs. 17.46 kg/m(2)+/- 2.67; p < 0.0001). TS thickness was similar in both groups (20.28 mm +/- 8.24 vs. 19.61 mm +/- 6.60; p > 0.05). Physical activity was Lower in study group (extra-school physical activity > 1 h: 21.25% vs. 46.87%; p < 0.001). Daily calcium intake was not associated with DFF incidence (918.75 mg/day +/- 338.04 vs. 886.13 mg/day +/- 382.77; p > 0.05). BMD was tower in fractured children (0.2591 g/cm(2)+/- 0.0413 vs. 0.2801 g/cm(2)+/- 0.0300; p < 0.0001) Summary: Our results suggest that significantly reduced bone mineral density, overweight and low physical activity are potential risk factors for fracture of the distal forearm, whilst low dietary intakes of calcium do not seem to be associated. The current epidemic of infantile overweight might explain the increased incidence of fractures of the distal forearm. (c) 2009 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L. All rights reserved.