Fracture interaction in the extremities, The possible relevance of posttraumatic osteopenia

Regional osteopenia may persist after certain types of fractures. To investigate the practical importance of this observation, the authors studied 2744 past fractures in 1659 patients with present fractures. Radial fractures rarely occurred ipsilateral to previous radial fractures, whereas fractures of the hand were more often ipsilateral to previous hand fractures. Hip fractures rarely recurred in the same hips. Patients with previous cervical hip fractures, unlike those with previous trochanteric fractures, had a predominance of subsequent fractures distal to the hip ipsilaterally. Those with previous femoral shaft fractures were more likely to have subsequent fractures ipsilaterally. Both femoral shaft and patellar fractures were more often seen on the side of previous lower extremity fractures. Patients with previous tibial fractures had more subsequent fractures of the femur and tibia ipsilaterally, and their present tibial fractures were more frequently ipsilateral when these fracture types had occurred in the past. Some of these shifts from the equal distribution of fractures between the two sides may be due to posttraumatic osteopenia.