Amyotrophic lateral sclerosis and history of skeletal fracture: a case-control study

A retrospective case-control study was conducted, using 66 amyotrophic lateral sclerosis (ALS) patients and 66 closely matched controls. Cases were ascertained primarily through a neurology clinic. A self-administered questionnaire probed for history of skeletal fractures. Using McNemar's test, no association was found between history of skeletal fracture and pathogenesis of ALS. No predilection for the head, neck, or spine was demonstrated. The extremities accounted for most fracture sites in cases and controls. Among cases, 68% of the fractures occurred before diagnosis, 58% occurring more than 10 years before diagnosis of ALS.