The sequelae of vertebral crush fractures in men

Abstract

The number of osteoporotic fractures is rising in men and women, because of the demographic trend towards an aging population and an increase in the age-specific incidence of fractures. Although previous studies have examined the morbidity following hip fractures in women, there is little information on the sequelae of vertebral crush fractures in men. We have therefore collected data on loss of height, kyphosis, peripheral fractures and functional status in 63 men with symptomatic vertebral fractures. Loss of height was documented in 49% of the men, while kyphosis was present in 54%. A past history of 50 non-vertebral fractures was obtained in 27 patients (43%), involving the ribs (17), lower arm (13) and femoral neck (4). Each patient then completed the Nottingham Health Profile (NHP), which gives information on perceived health. Men with vertebral crush fractures had higher scores for all six domains of the NHP when compared with age-matched and more elderly control subjects, implying greater morbidity. This was particularly marked for the energy, pain and mobility domains of the NHP. We conclude that there is considerable morbidity associated with vertebral crush fractures in men, which should be assessed in any trial of therapeutic intervention. This study suggests that the NHP may be a useful instrument in this regard.