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Wheelchair use cited as risk factor for fracture in male patients with muscular dystrophy
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Recently published data revealed full-time wheelchair use as a significant risk factor of first fracture among pediatric male patients with Duchenne or Becker muscular dystrophy, but found no correlation between fracture and corticosteroid use in this population.
Using the Muscular Dystrophy Surveillance, Tracking and Research Network, researchers retrospectively identified and followed 747 male patients with Duchenne or Becker muscular dystrophy. Patients were from Arizona, Colorado, Georgia, Iowa and western New York, and were born between 1982 and 2006. A multivariate Cox proportional hazard model was used to determine risk factors that correlated with first fracture. The investigated potential risk factors included race/ethnicity, surveillance site, status of ambulation, use and duration of calcium/vitamin D, use and duration of bisphosphonates, and use and duration of corticosteroids.
Investigators identified 249 patients who had at least one fracture. These patients had a mean age of 11.3 years at the time of fracture. There were 264 fractures overall, and 14 simultaneous incidences of fracture.
Although investigators found prior bisphosphonate use was higher in patients with fractures compared with patients who did not sustain a fracture, there were no differences between the groups regarding duration of use and median age at first use. Investigators also found no significant links between fracture and corticosteroid or bisphosphate use, and calcium/vitamin D.
Results of a Cox proportional hazards model showed full-time wheelchair use was a significant risk factor for first fracture, and the risk of fracture increased 75% for every 3 months a wheelchair was used. ‒ by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.
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