ArticleThe Journal of clinical endocrinology and metabolism2011
Approach to the child with fractures.
Article in The Journal of clinical endocrinology and metabolism, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 62 citations in OpenAlex.
- Practical approach to the diagnosis, management, and treatment of pediatric patients with bone fragility: an expert opinion.Journal of endocrinological investigation · 2026Review
- Low BMD is uncommon in pediatric mastocytosis: a DEXA- based cohort study.European journal of pediatrics · 2026Article
- Epidemiology of Pediatric Trauma and its Outcome Presenting to an Emergency Department in a Tertiary Care Hospital in Oman.Oman medical journal · 2025Article
- Impact of outer width of the metacarpal diaphysis on the identification of low bone mass in children.PloS one · 2025Article
- Vitamin D Levels During Fracture Healing in Children.Physiological research · 2024Article
- Updated reference values for BMD and lean mass measured by DXA in Thai children.Journal of bone and mineral metabolism · 2024Article
- Comminuted, displaced, and angulated distal radial and ulnar metaphyseal fractures after a trampoline park accident.Orthopedic reviews · 2024Article
- Orthopedic manifestations of child abuse.Pediatric research · 2022Review
- Osteoporosis in children and adolescents: when to suspect and how to diagnose it.European journal of pediatrics · 2022Review
- Risk Factors, Diagnosis and Management of Bone Stress Injuries in Adolescent Athletes: A Narrative Review.Sports (Basel, Switzerland) · 2021Review
- Valgus-impacted fracture of neck of femur in a 12-year-old child.BMJ case reports · 2021Article
- Effect of Vertebral Fracture on Auxological Profiles of Children Undergoing Acute Lymphoblastic Leukemia Treatment.Frontiers in pediatrics · 2021Article
- Real-world impact of glucocorticoid replacement therapy on bone mineral density: retrospective experience of a large single-center CAH cohort spanning 24 years.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Impaired Bone Mineral Density in Pediatric Patients with Chronic Graft-versus-Host Disease.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2018Article
- Child with multiple fractures: a rare presentation of a common disease.BMJ case reports · 2017Article
- A Subtrochanteric Femoral Stress Fracture following Bisphosphonate Treatment in an Adolescent Girl.Hormone research in paediatrics · 2017Article
- High prevalence of vitamin D deficiency in 2-17 year olds presenting with acute fractures in southern Australia.Bone reports · 2016Article
- Vitamin D Deficiency in Pediatric Fracture Patients: Prevalence, Risk Factors, and Vitamin D Supplementation.Journal of clinical research in pediatric endocrinology · 2016Article
- Reference values of bone stiffness index and C-terminal telopeptide in healthy European children.International journal of obesity (2005) · 2014Article
- Osteoporosis in young adults: pathophysiology, diagnosis, and management.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2012Review
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Evaluation of the child with fractures is challenging, as no clear guidelines exist to distinguish traumatic from pathological fractures. Although most fractures in childhood are benign, recurrent fractures may be associated with a wide variety of primary skeletal diseases as well as secondary causes, necessitating a careful history and physical exam to guide the evaluation. There is no "gold standard" for the evaluation and treatment of children with fractures and low bone mineral density (BMD); therefore, the diagnosis of osteoporosis in a pediatric patient should be made using a combination of clinical and radiographic features. Interpretation of bone densitometry in growing patients presents a unique set of challenges because areal BMD measured by dual-energy x-ray absorptiometry depends on multiple dynamic variables. Interpretation of pediatric dual-energy x-ray absorptiometry should be based on Z-scores (sd scores compared to age, sex, and ethnicity-matched controls), using normative databases specific to the brand of densitometer and the patient population. Given the skeleton's ability to recover from low BMD through modeling and remodeling, optimizing management of underlying conditions leading to bone fragility is the initial step. Conservative measures including calcium and vitamin D supplementation and weight-bearing physical activity are important interventions that should not be overlooked. The use of bisphosphonates in children and adolescents is controversial due to lack of long-term efficacy and safety data and should be limited to clinical trials and compassionate therapy in children with significantly compromised quality of life. Close monitoring is required, and further study is necessary to assess their long-term safety and efficacy in children.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.