Children with mild trauma fractures have lower bone strength 

Children with forearm fractures that occurred due to mild trauma have lower bone strength compared to other children, predisposing them to osteoporotic fractures later in life, according to a recently published study.

“Our study highlights the need for clinicians to consider the level of trauma preceding the injury, when treating children and adolescents who present with fractures,” Joshua Farr, PhD, a research fellow at Mayo Clinic in Rochester, stated. “Fractures from moderate trauma appear more likely to occur in the setting of normal bone strength. But fractures resulting from mild trauma suggest an underlying skeletal deficit.”

The researchers compared bone strength in children with recent distal forearm fractures due to mild trauma, defined as a fall from standing height, with children with distal forearm fractures due to moderate trauma, defined as a fall from a relatively low height, and children without fractures. To assess bone strength and quality, the children underwent high-resolution peripheral quantitative CT. Researchers assigned trauma levels based on clinical notes, radiology reports and interviews with clinicians, parents and patients.

Children with mild-trauma distal forearm fractures had weaker bones compared to children in the control group, which were able to tolerate less stress before fracturing, and had thinner cortical bone.

“We can’t say with certainty that these skeletal deficits will track into adulthood. They may be transient,” Farr stated. “But we think that trauma classification is a clinical variable that could be used to more closely monitor kids who are suffering mild trauma fractures. Intervention in terms of diet and physical activity might be used to optimize bone strength.”

Disclosure: Funding for this research was provided by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the Mayo Clinic’s Clinical and Translational Science Award.