Breaking bones in childhood more than doubles the odds of it happening again as an adult, finds study

Dunedin, December 18

Breaking a bone in childhood is not just a rite of passage. It could be a warning sign of future fracture risk and osteoporosis.

A history of prior fracture is one of the strongest predictors of future fractures, yet current guidelines used to determine osteoporosis risk ignore childhood fractures.

Researchers at University of Otago investigated the history of fractures in a group of middle-aged people who are part of the Dunedin Study, a comprehensive longitudinal project that has continued for five decades.

They found people who broke a bone more than once in their childhood had more than double the odds of breaking a bone as an adult. In women, this also resulted in lower bone density at the hip at age 45.

The people in their study were young for investigating fracture risk and osteoporosis, but if lifestyle changes to improve bone density can be implemented earlier in life, it may have the greatest impact on lifelong bone health and the reduction of osteoporosis risk.

Childhood fractures predict osteoporosis risk          

About one in two children break a bone during childhood, with almost a quarter of boys and 15 per cent of girls suffering multiple fractures.

But we don’t currently fully understand why some children repeatedly break bones or whether this will predict adult bone health.

There are several reasons why children fracture a bone. Previous research has shown that kids who fracture tend to live in poorer households, have high levels of vigorous exercise, are overweight or have a high body mass index, vitamin D insufficiency, low calcium intakes and may experience physical abuse.

Children who fracture repeatedly may also have especially fragile skeletons, they may be “accident-prone”, or their bone fractures may occur during sport or physical activity.

But an important question is whether kids who break bones have temporary reductions in bone strength during rapid growth, or if these bone weaknesses continue into adulthood.

The people studied were all part of the unique Dunedin Study, which tracked the development of a thousand babies born in Otepoti Dunedin between April 1972 and March 1973.

The researchers found both boys and girls who suffered more than one fracture as a child were more than twice as likely to fracture as an adult. Also, those who were fracture-free in childhood tended to stay so in adulthood.

Among females, childhood fractures were associated with lower bone mineral density at the hip later in life, but this was not the case among males.

Why this matters

Parents of children who repeatedly fracture in childhood should be informed about various ways to prevent persistent skeletal fragility with age. The Conversation