The full content of Annals is available to subscribers

Subscribe/Learn More  >
Original Research |

Which Fractures Are Associated with Low Appendicular Bone Mass in Elderly Women?

Dana G. Seeley, MS; Warren S. Browner, MD, MPH; Michael C. Nevitt, PhD; Harry K. Genant, MD; Jean C. Scott, RN, MPH; Steven R. Cummings, MD, Study of Osteoporotic Fractures Research Group*
[+] Article, Author, and Disclosure Information

Grant Support: By Public Health Service grants AG05394, AG05407, AR35582, AR35583, and AR35584.

Requests for Reprints: Dana G. Seeley, MS, Department of Epidemiology and Biostatistics, University of California, 74 New Montgomery, Suite 600, San Francisco, CA 94105.

Current Author Addresses: Ms. Seeley and Drs. Browner, Cummings, and Nevitt: Department of Epidemiology and Biostatistics, University of California, 74 New Montgomery, Suite 600, San Francisco, CA 94105.

Ms. Scott: University of Maryland, Department of Epidemiology and Preventive Medicine, 660 West Redwood Street, Howard Hall, Room 140, Baltimore, MD 21201.

Dr. Genant: Department of Radiology, University of California, Box 0628. San Francisco, CA 94143.

From the University of California, San Francisco, California; and the University of Maryland, Baltimore, Maryland. For current author addresses, see end of text.*For members of the Study of Osteoporotic Fractures Research Group, see the Appendix.

© 1991 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1991;115(11):837-842. doi:10.7326/0003-4819-115-11-837
Text Size: A A A

Objective: To determine which types of fractures have an increased incidence in elderly women with low appendicular bone mass.

Design: Prospective cohort study.

Setting: Four clinical centers in the United States (Baltimore, Maryland; Minneapolis, Minnesota; Portland, Oregon; Monangehela Valley, Pennsylvania); and one coordinating center in San Francisco, California.

Subjects: Ambulatory, nonblack women (9704) aged 65 years or more who were recruited from population-based listings.

Measurements: We measured bone mass at the distal and proximal radius and calcaneus using single-photon absorptiometry. Fractures were verified radiographically. Associations were calculated as age-adjusted hazard ratios (with 95% CIs) per standard deviation decrease in bone mass.

Main Results: During a mean follow-up of 2.23 years, 841 nonspinal fractures occurred in 753 women. The risks for fractures of the wrist, foot, humerus, hip, rib, toe, leg, pelvis, hand, and clavicle were significantly related to reduced bone mass (P < 0.05). These fractures represented 74% of nonspinal fractures. The overall hazard ratio for the occurrence of one or more of these fractures was 1.65 (Cl, 1.49 to 1.82) at the distal radius. In a subsample of the cohort, vertebral fractures were also related to low bone mass. Fractures of the ankle, elbow, finger, and face, however, were not associated with bone mass at any measurement site; the overall hazard ratio for these fractures was 1.12 (Cl, 0.96 to 1.30) at the distal radius.

Conclusion: Most types of fractures have an increased incidence in elderly women with low bone mass.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.