OSTEOPENIA IN ALCOHOLICS AFTER TIBIA SHAFT FRACTURES

• Published in: Alcohol and alcoholism (Oxford) Vol. 32; no. 5; pp. 599 - 604
• Main Authors: NYQUIST, FREDRIK, KARLSSON, MAGNUS K., OBRANT, KARL J., NILSSON, J.-Å.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-09-1997
• Subjects: Adult; Aged; Alcoholism - complications; Alcoholism - epidemiology; Alcoholism and acute alcohol poisoning; Biological and medical sciences; Bone Density; Bone Diseases, Metabolic - epidemiology; Bone Diseases, Metabolic - etiology; Comorbidity; Cross-Sectional Studies; Humans; Male; Medical sciences; Middle Aged; Tibia - injuries; Tibial Fractures - complications; Toxicology; Human; Ethanol; Toxicity; Alcoholism; Diseases of the osteoarticular system; Bone disease; Fracture; Medical screening; Trauma; X ray absorption spectrometry; Investigation method; Tibia; Complication; Bone; Osteopenia; Ultrasonic method
• ISSN: 0735-0414; 1464-3502
• DOI: 10.1093/oxfordjournals.alcalc.a008301

A marked reduction of 40–70% in regional bone mineral density (BMD) has been reported after fractures of long bones, and this post-traumatic osteopenia may to some extent persist for several years, perhaps lifelong. In this cross-sectional study, we investigated whether prolonged alcohol abuse had any effect on the degree of post-traumatic osteopenia after isolated tibia shaft fractures, the rationale for such a suspicion being the deranged bone metabolism found in alcoholics. We also wanted to investigate whether dual energy X-ray absorptiometry (DEXA) or quantitative ultrasound technique could detect differences between abusers and non-abusers in post-traumatic bone loss. We measured the BMD in 61 male patients with isolated tibia shaft fractures (1984–94) with the Lunar DPX-L® and the Lunar Achilles®. Twenty-four of the patients were verified to be high consumers of alcohol. After correction for differences in age and the time elapsed since the fracture event, we found significantly lower (11%; P=0.017) BMD in the femoral neck of the fractured leg in abusers when utilizing the DEXA technique. No differences between abusers and non-abusers in BMD were detectable when using the ultrasound technique. We found a fair correlation (r=0.63–0.81) between the DEXA and the ultrasound techniques in regions with spongious bone. Our findings suggest that alcohol abuse has some, albeit a limited, effect on the degree of post-traumatic osteopenia and that ultrasound measurements in the calcaneus are of little use in detecting an increased post-traumatic osteopenia in this patient group.