Ma Deqiong, Morley Ruth, Jones Graeme
Menzies Research Institute, Private Bag 23, Hobart, Tasmania, Australia 7000.
Osteoporos Int. 2004 Aug;15(8):633-8. doi: 10.1007/s00198-003-1579-9. Epub 2004 Jan 21.
The aim of this population based case-control study was to examine the association between risk-taking behaviour, motor coordination and upper limb fractures in children aged 9-16 years. A total of 321 fracture cases and 321 randomly selected individually matched controls were studied. The number for different types of upper limb fractures was 91 for hand, 190 for wrist and forearm and 40 for upper arm. Risk-taking behaviour was determined by a 5-item interview-administered questionnaire. Motor coordination was assessed by the 8-point movement ABC that tests manual dexterity, ball skills as well as static and dynamic balance. Bone mass was assessed by dual energy X-ray absorptiometry (DXA) and metacarpal morphometry. In general, there was heterogeneity by fracture site with regard to associations. Risk-taking behaviour was associated with hand fracture risk but not other fracture sites for downhill cycling behaviour (OR: 2.0/category, 95% CI: 1.1-3.7), dare behaviour (OR: 3.3/category, 95% CI: 1.1-10.0) and total risk-taking score (OR: 2.6/category, 95% CI: 1.3-5.7). Conversely, coordination measures were associated with wrist and forearm fractures only: cutting/threading (OR: 1.2/unit, 95% CI: 1.0-1.4); flower trail (OR: 1.2/unit, 95% CI: 1.0-1.4) and dynamic balance score (OR: 1.1/unit, 95% CI: 1.0-1.2). Backward stepwise analysis selected total risk taking score for hand fracture, and dynamic balance score for wrist and forearm fracture. None of the risk-taking or coordination scores were associated with upper arm fractures. These associations were unchanged following adjustment for bone mass. In conclusion, the propensity to take risks is most strongly associated with hand fracture risk while dynamic balance is most strongly associated with wrist and forearm fracture risk in children. These results inform the development of fracture prevention strategies in children.
这项基于人群的病例对照研究旨在探讨9至16岁儿童的冒险行为、运动协调性与上肢骨折之间的关联。共研究了321例骨折病例和321名随机选取的个体匹配对照。不同类型上肢骨折的数量分别为手部91例、腕部和前臂190例、上臂40例。冒险行为通过一份由访谈进行的5项问卷来确定。运动协调性通过8分运动ABC进行评估，该测试评估手部灵活性、球类技能以及静态和动态平衡。骨量通过双能X线吸收法（DXA）和掌骨形态测量法进行评估。总体而言，骨折部位在关联方面存在异质性。冒险行为与手部骨折风险相关，但与下坡骑行行为（比值比：2.0/类别，95%置信区间：1.1 - 3.7）、大胆行为（比值比：3.3/类别，95%置信区间：1.1 - 10.0）和总冒险得分（比值比：2.6/类别，95%置信区间：1.3 - 5.7）的其他骨折部位无关。相反，协调性指标仅与腕部和前臂骨折相关：剪裁/穿线（比值比：1.2/单位，95%置信区间：1.0 - 1.4）；花型轨迹（比值比：1.2/单位，95%置信区间：1.0 - 1.4）和动态平衡得分（比值比：1.1/单位，95%置信区间：1.0 - 1.2）。向后逐步分析选择了手部骨折的总冒险得分以及腕部和前臂骨折的动态平衡得分。冒险或协调性得分均与上臂骨折无关。在对骨量进行调整后，这些关联没有变化。总之，冒险倾向与儿童手部骨折风险关联最为密切，而动态平衡与儿童腕部和前臂骨折风险关联最为密切。这些结果为儿童骨折预防策略的制定提供了依据。
