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Osteopenia in alcoholics after tibia shaft fractures
F Nyquist1, M K Karlsson, K J Obrant
1Department of Orthopaedics, Malmö University Hospital, Lund University, Sweden.
Alcohol and Alcoholism (Oxford, Oxfordshire)
|November 28, 1997
Summary
Prolonged alcohol abuse slightly reduces bone mineral density (BMD) after tibia fractures, particularly in the femoral neck. Ultrasound techniques were less effective than DEXA in detecting this alcohol-related bone loss.
Area of Science:
- Orthopedics
- Bone Metabolism
- Radiology
Background:
- Post-traumatic osteopenia is a common complication after long bone fractures, potentially leading to long-term bone density reduction.
- Alcohol abuse is known to disrupt bone metabolism, raising concerns about its impact on fracture healing and recovery.
Purpose of the Study:
- To investigate the effect of prolonged alcohol abuse on post-traumatic osteopenia following isolated tibia shaft fractures.
- To compare the efficacy of dual energy X-ray absorptiometry (DEXA) and quantitative ultrasound (QUS) in detecting alcohol-related bone loss.
Main Methods:
- Cross-sectional study of 61 male patients with isolated tibia shaft fractures (1984-1994).
- Bone mineral density (BMD) measured using Lunar DPX-L (DEXA) and Lunar Achilles (QUS).
- Patients categorized into alcohol abusers (n=24) and non-abusers based on consumption.
Main Results:
- Alcohol abusers showed significantly lower BMD (11%, P=0.017) in the femoral neck of the fractured leg compared to non-abusers, as detected by DEXA.
- No significant differences in BMD were found between groups using the ultrasound technique.
- A fair correlation (r=0.63-0.81) was observed between DEXA and QUS in spongious bone regions.
Conclusions:
- Prolonged alcohol abuse has a limited but significant negative effect on regional bone mineral density following tibia shaft fractures.
- DEXA is more sensitive than QUS in detecting alcohol-induced post-traumatic bone loss in this patient cohort.
- Ultrasound measurements of the calcaneus are not recommended for assessing increased post-traumatic osteopenia in patients with a history of alcohol abuse.