A historical study of appendicular fractures in veterans with traumatic chronic spinal cord injury: 2002-2007

• Published in: The journal of spinal cord medicine Vol. 39; no. 6; pp. 686 - 692
• Main Authors: Bethel, Monique, Bailey, Lauren, Weaver, Frances, Harmon, Robert L., Priebe, Michael M., Le, Brian, Aslam, Hammad, Fausel, Zachary, Hoenig, Helen, Carbone, Laura D.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.11.2016
• Subjects: Adult; Aged; Bone fractures; Epidemiology; Female; Fractures, Bone - epidemiology; Humans; Male; Middle Aged; Osteoporosis; Retrospective Studies; Spinal cord injuries; Spinal Cord Injuries - epidemiology; Osteoporosis; Spinal cord injuries; Epidemiology; Bone fractures
• ISSN: 1079-0268; 2045-7723
• DOI: 10.1080/10790268.2016.1149930

Objective: Describe the incidence and distribution of appendicular fractures in a cohort of veterans with spinal cord injury (SCI). Design: Retrospective, observational study of fractures in veterans with a chronic traumatic SCI. Setting: The Veterans Health Administration (VA) healthcare system. Participants: Veterans included in the VA Spinal Cord Dysfunction Registry from Fiscal Years (FY) FY2002-FY2007. Interventions: Not applicable. Main Outcome Measures: Description of fractures by site and number. Mortality at one year following incident fracture among men with single vs. multiple fractures. Results: Male and female veterans sustained incident fractures with similar observed frequency (10.5% vs 11.5%). The majority of fractures occurred in the lower extremities for both men and women. In men, a complete extent of injury (compared to incomplete) was associated with 41% greater relative risk (RR) of incident fracture (RR 1.41, 95% confidence interval [1.17, 1.70]) among those with tetraplegia, but not paraplegia. Furthermore, many men (33.9%, n = 434) sustained multiple fractures over the course of the study. There were no differences in mortality between men who sustained a single fracture and those who had multiple fractures. Conclusions: The extent of injury may be an important predictor of fracture risk for male veterans with tetraplegia. Once a fracture occurs, male veterans with SCI appear to be at high risk for additional fractures.