DEVELOPMENT OF OSTEOPENIA IN THE HEMIPLEGIC FINGER IN PATIENTS WITH STROKE

Previous studies have demonstrated that hip fractures in stroke patien ts occurred almost exclusively on the hemiplegic side. We examined the bone changes in the second metacarpal of the hemiplegic side in terms of microdensitometric indices in 93 stroke patients with hemiplegia. All six indices indicated a significant decrease in bone mass on the h emiplegic side compared with the contralateral side. Differences in th e indices between the hemiplegic and contralateral sides were correlat ed well with the duration of the illness and Brunstrom's stage for fin ger, arm, and leg. The same degree of osteopenia occurred in both smal l capsular and large hemispheric lesions. The same osteopenia was demo nstrated in paralyzed and immobilized patients with myopathy. Thus a c ombination of weakness and immobilization is thought to be responsible for the osteopenia in the hemiplegic metacarpal bone. The osteopenia noted in the second metacarpal in the affected limb may account for th e fact that hip fractures in stroke patients occur almost exclusively on the hemiplegic side.