Fracture threshold and risk for osteoporosis and pathologic fractures in individuals with spinal cord injury

Abstract

The fracture threshold at the knee is a bone mineral density (BMD) of .78 gm/cm 2 (-36% loss), while the breakpoint is .49 gm/cm 2 (-57% loss). Using the knee as a proxy for the entire lower extremity (LE), fractures in the LE begin to occur when the BMD at the knee is .86 gm/cm 2 (-25% loss) and peak at .49 gm/cm 2 (-57% loss). Risk factors for fracture and osteoporosis include completeness of injury, paraplegia, body mass index (BMI) < 25 kg/m 2, increasing age and duration of injury, female gender, and previous fracture. A woman with complete paraplegia and a BMI less than 25 kg/m 2 is an appropriate candidate for early osteoporosis treatment. © 2005 Thomas Land Publishers, Inc.