The relationship between fractures and DXA measures of BMD in the distal femur of children and adolescents with cerebral palsy or muscular dystrophy.
The relationship between fractures and DXA measures of BMD in the distal femur of children and adolescents with cerebral palsy or muscular dystrophy.
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DOI：
10.1359/jbmr.091007
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发表时间：
2010-03
期刊：
影响因子：
--
通讯作者：
Harcke HT
中科院分区：
文献类型：
--
作者：
Henderson RC;Berglund LM;May R;Zemel BS;Grossberg RI;Johnson J;Plotkin H;Stevenson RD;Szalay E;Wong B;Kecskemethy HH;Harcke HT
行动能力有限或没有行走能力的儿童经常发生脆性骨折。关节痉挛、脊柱侧弯、髋关节发育不良和金属植入物往往妨碍了股骨近端和腰椎骨密度(BMD)的可靠测量，而股骨近端和腰椎是骨密度的常用测量对象。此外，腰椎骨密度与骨折风险在这一人群中的相关性是值得怀疑的。为了获得既在技术上可行又在临床上相关的骨密度测量，开发了一种包括股骨远端投射在侧平面上的双能X射线吸收测量(DXA)的技术。这项研究的目的是检验这样一种假设，即这些新的骨密度测量方法与行走能力有限或没有行走能力的儿童的骨折有关。对来自8个中心的619名患有肌肉营养不良或中重度脑瘫的儿童进行了横断面研究，评估了股骨远端骨密度Z分数与骨折史之间的关系。骨折病史与股骨远端骨密度Z值有很强的相关性；骨密度Z值小于−5的患者中有35%~42%发生过骨折，而骨密度Z值大于−1的患者有13%~15%发生过骨折。在临床实践中，DXA测量股骨远端的骨密度是评估活动能力受损儿童的首选技术。©2010美国骨与矿物研究学会
Children with limited or no ability to ambulate frequently sustain fragility fractures. Joint contractures, scoliosis, hip dysplasia, and metallic implants often prevent reliable measures of bone mineral density (BMD) in the proximal femur and lumbar spine, where BMD is commonly measured. Further, the relevance of lumbar spine BMD to fracture risk in this population is questionable. In an effort to obtain bone density measures that are both technically feasible and clinically relevant, a technique was developed involving dual-energy X-ray absorptiometry (DXA) measures of the distal femur projected in the lateral plane. The purpose of this study is to test the hypothesis that these new measures of BMD correlate with fractures in children with limited or no ability to ambulate. The relationship between distal femur BMD Z-scores and fracture history was assessed in a cross-sectional study of 619 children aged 6 to 18 years with muscular dystrophy or moderate to severe cerebral palsy compiled from eight centers. There was a strong correlation between fracture history and BMD Z-scores in the distal femur; 35% to 42% of those with BMD Z-scores less than −5 had fractured compared with 13% to 15% of those with BMD Z-scores greater than −1. Risk ratios were 1.06 to 1.15 (95% confidence interval 1.04–1.22), meaning a 6% to 15% increased risk of fracture with each 1.0 decrease in BMD Z-score. In clinical practice, DXA measure of BMD in the distal femur is the technique of choice for the assessment of children with impaired mobility. © 2010 American Society for Bone and Mineral Research
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影响因子：
4
作者：
Ismail, AA;O'Neill, TW;Silman, AJ
通讯作者：
Silman, AJ
影响因子：
3.8
作者：
Henderson, RC;Kairalla, J;Stevenson, RD
通讯作者：
Stevenson, RD
DOI：
10.2106/00004623-199511000-00005
发表时间：
1995-11-01
影响因子：
5.3
作者：
HENDERSON, RC;LIN, PP;GREENE, WB
通讯作者：
GREENE, WB
通过全息发现/Delphi双能X射线吸收测定法测量的修订后股骨远端股骨的修订小儿参考数据。
DOI：
10.1016/j.jocd.2009.01.005
发表时间：
2009-04
期刊：
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry
影响因子：
--
作者：
Zemel BS;Stallings VA;Leonard MB;Paulhamus DR;Kecskemethy HH;Harcke HT;Henderson RC
通讯作者：
Henderson RC
DOI：
10.1359/jbmr.060601
发表时间：
2006-09
期刊：
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
影响因子：
--
作者：
Clark EM;Ness AR;Bishop NJ;Tobias JH
通讯作者：
Tobias JH