Skip to main content
NCBI home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1996 Jun;50(3):288–292. doi: 10.1136/jech.50.3.288

Risk factors, falls, and fracture of the distal forearm in Manchester, UK.

T W O'Neill 1, D Marsden 1, J E Adams 1, A J Silman 1
PMCID: PMC1060285  PMID: 8935460

Abstract

OBJECTIVE: To determine the risk factors associated with fracture of the distal forearm, and to evaluate the influence of falls on these risks. DESIGN: This was a case-control study. SETTING: Manchester, UK. PARTICIPANTS: The cases were 62 white women aged 45-82 years who had sustained a fracture of the distal forearm and had attended local hospitals. Two control groups were studied - 50 women who had fallen onto the hand but had not sustained a fracture (recruited from the same source as those with fracture) and 116 women randomly selected from primary care age and sex registers in the catchment area of the hospitals. Both cases and controls were sent a letter inviting them to take part in the study. Data were collected by questionnaire completed by an interviewer. MAIN RESULTS: Compared with the population control group, those with fracture were more likely to walk at a brisk pace (odds ratio (OR) = 3.5; 95% confidence interval (CI) 1.3, 9.6) though they had undertaken less physical activity at home or work on a daily basis throughout life (OR = 0.4; 95% CI 0.2, 0.9). The risk associated with brisk walking was less marked when the cases were compared with fall controls. Other lifestyle factors including calcium intake, smoking, and alcohol consumption were not associated with fracture. Analysis of gynaecological and hormonal factors suggested that compared with population controls, those with fracture of the distal forearm had had fewer fertile years (OR = 0.4; 95% CI 0.1, 0.9) and were less likely to have used oral contraceptives (OR = 0.3; 95% CI 0.1, 0.9). CONCLUSIONS: The data highlight the need for caution when advising middle aged and elderly subjects about exercise. Such advice should be combined with practical information about the prevention of falls. Hormonal factors seem to be additional determinants of fracture. Other lifestyle interventions seem unlikely to play an important part in preventing distal forearm fracture.

Full text

PDF
288

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aniansson A., Zetterberg C., Hedberg M., Henriksson K. G. Impaired muscle function with aging. A background factor in the incidence of fractures of the proximal end of the femur. Clin Orthop Relat Res. 1984 Dec;(191):193–201. [PubMed] [Google Scholar]
  2. Cooper C., Barker D. J., Wickham C. Physical activity, muscle strength, and calcium intake in fracture of the proximal femur in Britain. BMJ. 1988 Dec 3;297(6661):1443–1446. doi: 10.1136/bmj.297.6661.1443. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cooper C., Hannaford P., Croft P., Kay C. R. Oral contraceptive pill use and fractures in women: a prospective study. Bone. 1993;14(1):41–45. doi: 10.1016/8756-3282(93)90254-8. [DOI] [PubMed] [Google Scholar]
  4. Cummings S. R., Kelsey J. L., Nevitt M. C., O'Dowd K. J. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev. 1985;7:178–208. doi: 10.1093/oxfordjournals.epirev.a036281. [DOI] [PubMed] [Google Scholar]
  5. Cummings S. R., Nevitt M. C. A hypothesis: the causes of hip fractures. J Gerontol. 1989 Jul;44(4):M107–M111. doi: 10.1093/geronj/44.4.m107. [DOI] [PubMed] [Google Scholar]
  6. Ettinger B., Genant H. K., Cann C. E. Long-term estrogen replacement therapy prevents bone loss and fractures. Ann Intern Med. 1985 Mar;102(3):319–324. doi: 10.7326/0003-4819-102-3-319. [DOI] [PubMed] [Google Scholar]
  7. Fiatarone M. A., Marks E. C., Ryan N. D., Meredith C. N., Lipsitz L. A., Evans W. J. High-intensity strength training in nonagenarians. Effects on skeletal muscle. JAMA. 1990 Jun 13;263(22):3029–3034. [PubMed] [Google Scholar]
  8. Goldsmith N. F., Johnston J. O. Bone mineral: effects of oral contraceptives, pregnancy, and lactation. J Bone Joint Surg Am. 1975 Jul;57(5):657–668. [PubMed] [Google Scholar]
  9. Gutin B., Kasper M. J. Can vigorous exercise play a role in osteoporosis prevention? A review. Osteoporos Int. 1992 Mar;2(2):55–69. doi: 10.1007/BF01623838. [DOI] [PubMed] [Google Scholar]
  10. Hutchinson T. A., Polansky S. M., Feinstein A. R. Post-menopausal oestrogens protect against fractures of hip and distal radius. A case-control study. Lancet. 1979 Oct 6;2(8145):705–709. doi: 10.1016/s0140-6736(79)90640-8. [DOI] [PubMed] [Google Scholar]
  11. Johnell O., Nilsson B. E. Life-style and bone mineral mass in perimenopausal women. Calcif Tissue Int. 1984 Jul;36(4):354–356. doi: 10.1007/BF02405345. [DOI] [PubMed] [Google Scholar]
  12. Kelsey J. L., Browner W. S., Seeley D. G., Nevitt M. C., Cummings S. R. Risk factors for fractures of the distal forearm and proximal humerus. The Study of Osteoporotic Fractures Research Group. Am J Epidemiol. 1992 Mar 1;135(5):477–489. doi: 10.1093/oxfordjournals.aje.a116314. [DOI] [PubMed] [Google Scholar]
  13. Lau E., Donnan S., Barker D. J., Cooper C. Physical activity and calcium intake in fracture of the proximal femur in Hong Kong. BMJ. 1988 Dec 3;297(6661):1441–1443. doi: 10.1136/bmj.297.6661.1441. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Law M. R., Wald N. J., Meade T. W. Strategies for prevention of osteoporosis and hip fracture. BMJ. 1991 Aug 24;303(6800):453–459. doi: 10.1136/bmj.303.6800.453. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Mallmin H., Ljunghall S., Persson I., Bergström R. Risk factors for fractures of the distal forearm: a population-based case-control study. Osteoporos Int. 1994 Nov;4(6):298–304. doi: 10.1007/BF01622186. [DOI] [PubMed] [Google Scholar]
  16. Pocock N. A., Eisman J. A., Yeates M. G., Sambrook P. N., Eberl S. Physical fitness is a major determinant of femoral neck and lumbar spine bone mineral density. J Clin Invest. 1986 Sep;78(3):618–621. doi: 10.1172/JCI112618. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Tylavsky F. A., Anderson J. J., Talmage R. V., Taft T. N. Are calcium intakes and physical activity patterns during adolescence related to radial bone mass of white college-age females? Osteoporos Int. 1992 Sep;2(5):232–240. doi: 10.1007/BF01624147. [DOI] [PubMed] [Google Scholar]
  18. Weiss N. S., Ure C. L., Ballard J. H., Williams A. R., Daling J. R. Decreased risk of fractures of the hip and lower forearm with postmenopausal use of estrogen. N Engl J Med. 1980 Nov 20;303(21):1195–1198. doi: 10.1056/NEJM198011203032102. [DOI] [PubMed] [Google Scholar]
  19. White M. K., Martin R. B., Yeater R. A., Butcher R. L., Radin E. L. The effects of exercise on the bones of postmenopausal women. Int Orthop. 1984;7(4):209–214. doi: 10.1007/BF00266829. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES