Search tips
Search criteria 


Logo of jepicomhJournal of Epidemiology and Community HealthVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Epidemiol Community Health. 1996 June; 50(3): 288–292.
PMCID: PMC1060285

Risk factors, falls, and fracture of the distal forearm in Manchester, UK.


OBJECTIVE: To determine the risk factors associated with fracture of the distal forearm, and to evaluate the influence of falls on these risks. DESIGN: This was a case-control study. SETTING: Manchester, UK. PARTICIPANTS: The cases were 62 white women aged 45-82 years who had sustained a fracture of the distal forearm and had attended local hospitals. Two control groups were studied - 50 women who had fallen onto the hand but had not sustained a fracture (recruited from the same source as those with fracture) and 116 women randomly selected from primary care age and sex registers in the catchment area of the hospitals. Both cases and controls were sent a letter inviting them to take part in the study. Data were collected by questionnaire completed by an interviewer. MAIN RESULTS: Compared with the population control group, those with fracture were more likely to walk at a brisk pace (odds ratio (OR) = 3.5; 95% confidence interval (CI) 1.3, 9.6) though they had undertaken less physical activity at home or work on a daily basis throughout life (OR = 0.4; 95% CI 0.2, 0.9). The risk associated with brisk walking was less marked when the cases were compared with fall controls. Other lifestyle factors including calcium intake, smoking, and alcohol consumption were not associated with fracture. Analysis of gynaecological and hormonal factors suggested that compared with population controls, those with fracture of the distal forearm had had fewer fertile years (OR = 0.4; 95% CI 0.1, 0.9) and were less likely to have used oral contraceptives (OR = 0.3; 95% CI 0.1, 0.9). CONCLUSIONS: The data highlight the need for caution when advising middle aged and elderly subjects about exercise. Such advice should be combined with practical information about the prevention of falls. Hormonal factors seem to be additional determinants of fracture. Other lifestyle interventions seem unlikely to play an important part in preventing distal forearm fracture.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (971K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Cummings SR, Kelsey JL, Nevitt MC, O'Dowd KJ. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev. 1985;7:178–208. [PubMed]
  • Cooper C, Barker DJ, Wickham C. Physical activity, muscle strength, and calcium intake in fracture of the proximal femur in Britain. BMJ. 1988 Dec 3;297(6661):1443–1446. [PMC free article] [PubMed]
  • Lau E, Donnan S, Barker DJ, Cooper C. Physical activity and calcium intake in fracture of the proximal femur in Hong Kong. BMJ. 1988 Dec 3;297(6661):1441–1443. [PMC free article] [PubMed]
  • Law MR, Wald NJ, Meade TW. Strategies for prevention of osteoporosis and hip fracture. BMJ. 1991 Aug 24;303(6800):453–459. [PMC free article] [PubMed]
  • Cummings SR, Nevitt MC. A hypothesis: the causes of hip fractures. J Gerontol. 1989 Jul;44(4):M107–M111. [PubMed]
  • Kelsey JL, Browner WS, Seeley DG, Nevitt MC, Cummings SR. Risk factors for fractures of the distal forearm and proximal humerus. The Study of Osteoporotic Fractures Research Group. Am J Epidemiol. 1992 Mar 1;135(5):477–489. [PubMed]
  • Mallmin H, Ljunghall S, Persson I, Bergström R. Risk factors for fractures of the distal forearm: a population-based case-control study. Osteoporos Int. 1994 Nov;4(6):298–304. [PubMed]
  • Hutchinson TA, Polansky SM, Feinstein AR. Post-menopausal oestrogens protect against fractures of hip and distal radius. A case-control study. Lancet. 1979 Oct 6;2(8145):705–709. [PubMed]
  • Weiss NS, Ure CL, Ballard JH, Williams AR, Daling JR. Decreased risk of fractures of the hip and lower forearm with postmenopausal use of estrogen. N Engl J Med. 1980 Nov 20;303(21):1195–1198. [PubMed]
  • Ettinger B, Genant HK, Cann CE. Long-term estrogen replacement therapy prevents bone loss and fractures. Ann Intern Med. 1985 Mar;102(3):319–324. [PubMed]
  • Cooper C, Hannaford P, Croft P, Kay CR. Oral contraceptive pill use and fractures in women: a prospective study. Bone. 1993;14(1):41–45. [PubMed]
  • Johnell O, Nilsson BE. Life-style and bone mineral mass in perimenopausal women. Calcif Tissue Int. 1984 Jul;36(4):354–356. [PubMed]
  • Goldsmith NF, Johnston JO. Bone mineral: effects of oral contraceptives, pregnancy, and lactation. J Bone Joint Surg Am. 1975 Jul;57(5):657–668. [PubMed]
  • Gutin B, Kasper MJ. Can vigorous exercise play a role in osteoporosis prevention? A review. Osteoporos Int. 1992 Mar;2(2):55–69. [PubMed]
  • Pocock NA, Eisman JA, Yeates MG, Sambrook PN, Eberl S. Physical fitness is a major determinant of femoral neck and lumbar spine bone mineral density. J Clin Invest. 1986 Sep;78(3):618–621. [PMC free article] [PubMed]
  • Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, Evans WJ. High-intensity strength training in nonagenarians. Effects on skeletal muscle. JAMA. 1990 Jun 13;263(22):3029–3034. [PubMed]
  • Aniansson A, Zetterberg C, Hedberg M, Henriksson KG. Impaired muscle function with aging. A background factor in the incidence of fractures of the proximal end of the femur. Clin Orthop Relat Res. 1984 Dec;(191):193–201. [PubMed]
  • White MK, Martin RB, Yeater RA, Butcher RL, Radin EL. The effects of exercise on the bones of postmenopausal women. Int Orthop. 1984;7(4):209–214. [PubMed]
  • Tylavsky FA, Anderson JJ, Talmage RV, Taft TN. Are calcium intakes and physical activity patterns during adolescence related to radial bone mass of white college-age females? Osteoporos Int. 1992 Sep;2(5):232–240. [PubMed]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group