Familial aggregation of fractures: a pilot study

Curtis, Sarah Joan (2011) Familial aggregation of fractures: a pilot study. Masters thesis, Memorial University of Newfoundland.

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Abstract

Background: Childhood fractures are common and preventable. They are a significant cause of morbidity and are relatively understudied. Some children may have readily identifiable risk factors and examination of this possibility will help our understanding of pediatric fractures. -- Objectives: To investigate familial, environmental and other complex influences on fracture risk in children. -- Design/Methods: Case-control study of 150 children with and without fracture. -- Results: Children with fractures were more likely to have a parental history of fracture (46.8% of cases versus 31.0% of control; p=0.007). Odds ratios for fracture were 2.2 (p=0.036), 2.03 (p=0.035) and 3.7 (p= 0.009) if the child's mother, father or both parents fractured respectively. Cases were twice as likely to have siblings and 1.5 times as likely to have first-degree relatives with fracture. Increased parental fracture burden was seen in families of children with multiple fractures. Groups did not differ with respect to environmental influences on fracture risk. -- Conclusions: There appears to be an increased familial clustering of childhood fractures as children with fractures are more likely to have parents and siblings with childhood fractures. Explanations for this association between parental fractures and increased risk of fracture for their children are currently unknown. This association should be validated in larger sample sizes and the relative impact of genetic, environmental and behavioral factors need to be further elucidated.

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