By Jo McCulty

Rodney Tomczak studies the relationship between bone fractures and osteoporosis.

Foot fractures may be sign of osteoporosis

A fractured foot bone could be a warning sign for osteoporosis, new research suggests.

An Ohio State study found that 20 out of 21 patients -- men and women alike -- with fractured foot bones had at least early signs of osteoporosis. The researchers considered these fractures"unexplained" -- that is, the cause couldn't be attributed to overuse, such as strenuous exercise, or a previous foot fracture.

"Each foot fracture had been caused by normal weight bearing -- some patients were walking when they felt their bones break," said Rodney Tomczak, co-author of the study and a clinical assistant professor of orthopedics at Ohio State.

"We found a correlation between these unexplained foot fractures and low bone density, one of the primary symptoms of osteoporosis."

Tomczak presented the research recently at the annual meeting of the American College of Foot and Ankle Surgeons. He conducted the study with Robert VanCourt, a clinical instructor in the Department of Orthopedics at Ohio State.

Osteoporosis is a disease that reduces bone density, causing bones to become frail and brittle. Usually thought to be a disorder that affects elderly women, the average age of women in this study was 54, and the average age of the men was 35.

Each patient -- 15 women and six men -- was initially seen for metatarsal -- or foot bone -- fractures. None of the fractures had been caused by strenuous activity, such as running or kicking, or by a blow to the foot. After the fractures were diagnosed, the patients underwent a bone density scan. Twenty of the patients had low bone densities -- a sign of osteoporosis. Every man in the study had the disorder.

"That was a startling find," Tomczak said."Men usually don't suffer from osteoporosis. But each man and most of the women (18 in all) had a medical condition that could contribute to the development of the disorder."

These conditions include kidney failure, insulin-dependent diabetes, menopause and low testosterone levels.

While inexplicable foot fractures can alert doctors to possible osteoporosis, a fracture isn't a definitive sign that a patient has the disease."Only through bone density testing can an early diagnosis of osteoporosis be made," Tomczak said.

"Podiatrists should carefully inspect their patients who may be at risk for developing osteoporosis," Tomczak said."The first manifestation of osteoporosis in many people is an unexplained foot fracture."

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