Fractures are common in otherwise healthy children and adolescents. They result from trauma of varying severity. Some reflect a greater skeletal fragility. A long-term implication of these fractures is their potentiality to predict adult bone fragility and increased risk of osteoporosis in later life. Using DXA, HR-pQCT and µFEA measurements, we previously found in 124 healthy females followed from the age of 7.9 to 20.4 years, substantial deficits in both structural and strength components of the radius in the 42 girls who sustained a fracture during skeletal development. The objective of the current study was to assess in healthy males the relationship between fracture during development and expression of bone fragility in adulthood. A cohort of 152 boys was followed from age 7.4 ± 04 (mean ± SD) to 22.6 ± 0.7 years, i.e. when peak bone mass is attained. Ninety participants (59.2%) sustained at least one fracture during growth, with highest incidence within the 10-13 year age range. Forearm was the most frequent site of fractures. At 7.4 years, several bone DXA-measured variables (aBMD, BMC) were lower in the group with a positive fracture history during skeletal development as compared to the non-fractured group. In contrast, at 22.6 years, no DXA-measured sites, including forearm, indicated a deficit in the fractured group as compared to the non-fractured group. Likewise, at 22.6 years, neither HR-pQCT nor µFEA measurements, including distal radius, showed a structural or strength deficit in the fractured group. These results markedly contrast with a similar prospective study using the same technical and clinical design in 124 healthy girls. In conclusion, our prospective studies suggest a gender difference in the predictability of bone fragility in young adults who sustained fractures during childhood and adolescence. This difference might be related to the degree of trauma severity, usually lower in girls than in boys. This article is protected by copyright. All rights reserved.
PMID: 28543781 [PubMed - as supplied by publisher]