Risk Taking and Fracture Study

Study Overview
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Brief Summary
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Boys suffer a disproportionately large number of fractures compared to girls (55-60%). This study aims to determine why this is the case by identifying risk factors for wrist fractures. The increase in fracture during childhood and adolescence may be associated with 1) risk-taking behaviour in boys, 2) obesity trends in boys during childhood and adolescence, and/or 3) impaired acquisition of bone strength during childhood and adolescence. Importantly from a knowledge translation perspective, modifiable factors such as behaviour, dietary habits or physical activity in boys may predict fracture. The investigators will measure 400 children (100 girls and 100 boys who have sustained a fracture; 100 same age and sex friends) across 4 years of growth. This study will assess risk behaviours, diet, physical activity, motor proficiency (i.e., balance and coordination), fat and muscle mass and bone strength to determine if there are, 1) differences in whether all or some of these factors predict fractures in boys compared with girls and, 2) whether these factors track forward similarly in boys compared with girls as children advance through the growth spurt.

Detailed Description
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The investigators aim to better characterize factors that contribute to fracture in boys and girls and to assess whether such factors track across a four year period. The innovation is to use novel methods and an integrated approach, to measure the influence of risk-taking behaviour, body composition, bone microstructure, motor proficiency, diet and physical activity in one model across growth. This will provide a more comprehensive picture of the key multi-factorial predictors of fracture within- and between-sexes. This essential information will provide the basis for change in public health policy, clinical practice, community programs, and targeted interventions.

Official Title
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An Investigation Into Risk Taking Behaviour, Bone Microstructure and Fracture Between the Sexes: What Underpins Fracture in Boys Compared to Girls During Growth?

Conditions
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Fracture

Intervention / Treatment
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* Other: Fracture - Boys
* Other: Fracture - Girls
* Other: Non Fracture - Boys
* Other: Non Fracture - Girls


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Boys aged 9-15 and Girls aged 8-13 Fracture to distal radius after low to moderate energy trauma No other health concerns Healthy (non fracture) subjects for comparison Exclusion Criteria: Fracture is a result of severe trauma Children with ontological medical conditions

Ages Eligible for Study
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Minimum Age: 8 Years
Maximum Age: 15 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Fracture - Boys<br>Boys who have sustained a distal radius fracture | Other: Fracture - Boys<br>* Annual measurements of risk taking behaviour, body composition, bone microstructure, balance, diet, and physical activity over 4 years<br>|
| Fracture - Girls<br>Girls who have sustained a distal radius fracture | Other: Fracture - Girls<br>* Annual measurements of risk taking behaviour, body composition, bone microstructure, balance, diet, and physical activity over 4 years<br>|
| Non Fracture - Boys<br>Boys who have not sustained a distal radius fracture | Other: Non Fracture - Boys<br>* Annual measurements of risk taking behaviour, body composition, bone microstructure, balance, diet, and physical activity over 4 years<br>|
| Non Fracture - Girls<br>Girls who have not sustained a distal radius fracture | Other: Non Fracture - Girls<br>* Annual measurements of risk taking behaviour, body composition, bone microstructure, balance, diet, and physical activity over 4 years<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Characterization of factors that contribute to fractures in boys and girls | The factors include: Risk taking behaviour - protection motivation variables, anticipated regret and excitement and impulsivity dispositions Body composition - total body mass, fat mass, lean mass Bone microstructure - cortical and trabecular bone outcomes Dietary intake - calcium Physical activity | Baseline (<3 months after injury) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tracking of Risk Factors | The outcomes will be measured across a 3 year interval (4 years in total) to determine whether factors track similarly in boys compared with girls over time and to assess their continued (or not) contribution to fracture. | 4 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Wrist Fracture, Adolescents, Risk Taking Behaviour, Bone Microstructure