Adolescents with Spina Bifida and Fractures

As your child with spina bifida gains greater independence, the risk of fracture of the upper or lower bones of the leg increases. Beginning at about age 11, fracture risk increases as the child becomes more independent and has less supervision. A study done in 2007 by a spina bifida program in Syracuse, New York, sought to determine the number of fractures in children, adolescents, and adults with spina bifida. They also wanted to answer what type of fracture for each age group and if there were risk factors for each age group.

Participants (221) in the study ranged in age from 2 to 58 years. Patient self-report of fractures, documentation of fractures, and personal identification such as age, sex, ability to walk, etc. were used for the study. The study documented fracture risk is greater in adolescence. The study was unable to comment on specific environmental risk factors, as many fractures were not witnessed. Consequently, the way in which the fracture was caused could not be identified. Authors also comment that bone density may also play a role in fracture risk.

The overall fracture among children, adolescents, and adults was from approximately 2% to 3%. The authors believed because adults were often overweight and not as active as children and adolescents, they may be at less risk for fracture, but the study indicated that weight and activity were not a contributing factor to lack of fracture. The conclusion of the study was making changes in environment of adolescent children may aid in preventing fractures. A future study for modification of environment for adolescents with spina bifida may be helpful.

For more information:”Incidence, prevalence, and characteristics of fractures in children, adolescents, and adults with spina bifida,” N. Dosa, MD, MPH; M. Eckrich, MD; D. Katz, MD; M. Turk, MD; G. Liptak, MD, MPH, Journal of Spinal Cord Medicine, 30(suppl 1): S5-SI, 2007.