Related Experiment Video
Updated: Jun 18, 2026
Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
Published on: April 11, 2012
Bone fracture in physically disabled children attending schools for handicapped children in Japan
Keiko Maruyama1, Kazutoshi Nakamura, Mitsue Nashimoto
1Department of Nursing, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 951-3198, Japan. maruyama@nuhw.ac.jp
Insights
Physically disabled children in Japan experience a high rate of bone fractures, with prevalence increasing with age. Joint contractures and older age are identified as key risk factors for fractures in this population.
Area of Science:
- Pediatrics
- Epidemiology
- Orthopedics
Background:
- Limited epidemiologic research exists on bone fractures in schools for children with disabilities (Yogo schools).
- Understanding fracture frequency and risk factors in physically disabled children is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence of bone fractures in physically disabled children in Japan.
- To identify risk factors associated with bone fractures in this vulnerable population.
Main Methods:
- A cross-sectional study surveyed 525 physically disabled children across 38 Yogo schools in Japan.
- Data collected included participant demographics, disability level, and detailed fracture history (lifetime and 1-year prevalence).
- Statistical analyses, including multiple logistic regression, were used to identify independent risk factors.
Main Results:
- The 1-year period prevalence of fractures was 3.6%, and lifetime prevalence was 9.7%.
- Fracture prevalence significantly increased with age, particularly in older age groups (13-15 years).
- Older age and the presence of lower limb or hip joint contractures were independently associated with a higher risk of bone fracture.
Conclusions:
- Physically disabled children exhibit a high risk for bone fractures.
- Age and joint contractures are significant risk factors, necessitating further investigation into other contributing factors.
Objective:
Very few epidemiologic studies on bone fracture have been conducted in schools for handicapped children (Yogo schools). The aim of this study was to clarify the frequency and risk factors of bone fracture in physically disabled children in Japan.
Methods:
We used a cross-sectional design to examine 525 physically disabled children in 38 Yogo schools in the Hokuriku-Koshinetsu District of Japan. The questionnaire surveyed information on participant sex, age, level of physical disability, and bone fracture history. Information on fractures was obtained, including number of fractures over participant lifetime, age when fractures occurred, location, and cause. One-year-period prevalence and lifetime prevalence were defined as the proportion of subjects with incident fractures in the previous year and with a history of fracture, respectively.
Results:
Participant ages ranged from 6 to 15 years, and 66.3% had cerebral palsy (CP). The 1-year-period prevalence was 3.6% and lifetime fracture prevalence was 9.7%. The 1-year-period prevalence in the age groups of 6-9, 10-12, and 13-15 years was 2/184 (1.1%), 5/171 (2.9%), and 12/164 (7.3%), respectively (P for trend = 0.0031). There were no differences in period prevalence between sexes, and this was not associated with presence of CP. Multiple logistic regression analysis showed that age and presence of one joint contracture in the lower limbs or hip were independently associated with occurrence of bone fracture over participant lifetime.
Conclusions:
Physically disabled children are at high risk of bone fracture, and further risk factors should be determined.
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...