Epidemiology of extraspinal fractures associated with acute spinal cord injury

Study design: A descriptive study of concurrent extraspinal fractures colle cted prospectively during initial hospital care. Objectives: To examine the frequency and related characteristics of concurr ent extraspinal fractures among patients with a new onset of spinal cord in jury (SCI). Setting: Model SCI care systems throughout the United States. Methods: A consecutive sample of 5711 subjects admitted to the National SCI Database between 1986 - 1995 was recruited to estimate the incidence of ex traspinal fractures associated with acute SCI, stratified by anatomic sites , demographics, and injury related characteristics. Results: Of 5711 subjects, 1585 (28%) patients had extraspinal fractures, 5 80 (37%) patients had more than one fracture site. The most common region o f fractures was chest, followed by lower extremity, upper extremity, head, others. and pelvis. The overall incidence rate was higher for women than me n, for whites than non-whites, for paraplegics than tetraplegics, and for t hose injured in motor vehicle crashes than others. Compared with patients h aving single fracture, those who had multiple fractures were likely to be w hite, paraplegic, and injured in motor vehicle crashes. There was no age di fference in the incidence of concurrent fractures, single or multiple. Conclusions: Extraspinal fractures are not uncommon at the same time as SCI The fracture occurrence varies by gender, race, injury level, and etiology of injury. The knowledge of these associated factors will aid in early rec ognition of fractures, preventing complications, and facilitating rapid mob ilization and rehabilitation outcomes among persons with SCI.