OSTEOPENIA IN ALCOHOLICS AFTER TIBIA SHAFT FRACTURES

A marked reduction of 40-70% in regional bone mineral density (BMD) ha s been reported after fractures of long bones, and this post-traumatic osteopenia may to some extent persist for several years, perhaps life long. In this cross-sectional study, we investigated whether prolonged alcohol abuse had any effect on the degree of post-traumatic osteopen ia after isolated tibia shaft fractures, the rationale for such a susp icion 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 B MD in 61 male patients with isolated tibia shaft fractures (1984-94) w ith the Lunar DPX-L-(R) and the Lunar Achilles((R)). Twenty-four of th e patients were verified to be high consumers of alcohol. After correc tion for differences in age and the time elapsed since the fracture ev ent, 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 detectabl e 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 grou p.