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American Journal of Epidemiology Vol. 155, No. 10 : 926-931
Copyright © 2002 by The Johns Hopkins University School of Hygiene and Public Health


ORIGINAL CONTRIBUTIONS

Foot Problems as Risk Factors of Fractures

Theresa H. M. Keegan1, Jennifer L. Kelsey1, Stephen Sidney2 and Charles P. Quesenberry, Jr.2

1 Division of Epidemiology, Stanford University School of Medicine, Stanford, CA.
2 Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA.

This case-control study examines whether foot problems are risk factors of fractures of five sites among people aged 45 years or older at six Kaiser Permanente Medical Centers in northern California. From October 1996 to May 2001, interviewers collected information through a standardized questionnaire. Incident cases of distal forearm (n = 1,000), foot (n = 827), proximal humerus (n = 448), shaft of the tibia/fibula (n = 168), and pelvis (n = 172) fractures and 1,913 controls from the same medical centers were included. After adjustment for potential confounders and for each additional foot problem, the odds of a foot fracture increased by 8% (adjusted odds ratio = 1.08, 95% confidence interval: 1.03, 1.13). In contrast, each additional foot problem was associated with a reduction in the odds of a forearm fracture (adjusted odds ratio = 0.93, 95% confidence interval: 0.89, 0.98). In general, foot problems were not related to fractures of other sites, although diabetes, which may result in foot problems, increased the odds of a proximal humerus fracture (adjusted odds ratio = 1.65, 95% confidence interval: 1.20, 2.26). If these findings are supported by data from other studies, preventive measures to retard the development of foot problems could reduce the incidence of foot fractures.

diabetes mellitus; foot; fractures; humeral fractures; radius fractures; tibial fractures; ulna fractures


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