Osteoporosis International

, Volume 14, Issue 11, pp 918–922 | Cite as

Left-handedness as a risk factor for fractures

  • Crystal M. LuettersEmail author
  • Jennifer L. Kelsey
  • Theresa H. M. Keegan
  • Charles P. Quesenberry
  • Stephen Sidney
Original Article


Left-handedness has been associated with increased fracture risk in a small number of previous studies. This study reports risks for fractures at the proximal humerus, distal forearm, pelvis, foot, and shaft of the tibia/fibula according to handedness in a case-control study conducted from October 1996 to May 2001 among members of Northern California Kaiser Permanente. Handedness was assessed by questionnaire for 2,841 cases and 2,192 controls, and subjects were categorized as left-handed, right-handed, ambidextrous, or forced to switch from the left to the right hand. Compared to right-handedness, left-handedness was most strongly associated with an increased risk for proximal humerus fractures (adjusted odds ratio (OR)=2.00, 95% confidence interval (CI) 1.33 to 3.01) and less definitively with fractures of the distal forearm (adjusted OR=1.28, 95% CI 0.92 to 1.80), foot (adjusted OR=1.17, 95% CI 0.82 to 1.65), and pelvis (adjusted OR=1.40, 95% CI 0.71 to 2.74). Ambidextrous individuals had elevated risks for fractures of the distal forearm (adjusted OR=2.99, 95% CI 1.42 to 6.30), foot (adjusted OR=2.59, 95% CI 1.13 to 5.97), shaft of the tibia/fibula (adjusted OR=3.91, 95% CI 1.01 to 15.17), and proximal humerus (adjusted OR=2.37, 95% CI 0.85 to 6.65) when compared with right-handed individuals. Those individuals forced to use the right hand demonstrated no increased risk for fractures at any site. These results suggest that handedness does influence fracture risk, but the reasons for this increased risk are unclear.


Ambidextrous Fractures Handedness Humeral fractures 


  1. 1.
    Seddon BM, McManus IC (1991) The incidence of left-handedness: a meta-analysis. Unpublished manuscript, University College, LondonGoogle Scholar
  2. 2.
    Geschwind N, Galaburda AM (1985) Cerebral lateralization: biological mechanisms, associations, and pathology (I, II, III). Arch Neurol 42:428–654PubMedGoogle Scholar
  3. 3.
    Searleman A, Coren S, Porac C (1989) Relationship between birth order, birth stress, and lateral preferences: a critical review. Psychol Bull 105:397–408CrossRefPubMedGoogle Scholar
  4. 4.
    McManus C (1991) The inheritance of left-handedness. In: Brock G, Marsh J (eds) Biological asymmetry and handedness. Ciba Foundation Symposium 162. Wiley, New York, pp 251–281Google Scholar
  5. 5.
    Hemenway D, Azrael DR, Rimm EB, Feskanich D, Willett W (1994) Risk factors for wrist fracture: effect of age, cigarettes, alcohol, body height, relative weight, and handedness on the risk for distal forearm fractures in men. Am J Epidemiol 140:361–367PubMedGoogle Scholar
  6. 6.
    Stellman S, Wynder E, DeRose D, Muscat J (1997) The epidemiology of left-handedness in a hospital population. Ann Epidemiol 7:167–171CrossRefPubMedGoogle Scholar
  7. 7.
    Flannery K, Leiderman J (1995) Is there really a syndrome involving the co-occurrence of neurodevelopmental disorder, talent, non right-handedness and immune disorder in children? Cortex 31:503–515PubMedGoogle Scholar
  8. 8.
    Kim H, Yi S, San EI, Kim J (2001) Evidence for the psychological right-handedness hypothesis. Neuropsychology 15:510–515CrossRefPubMedGoogle Scholar
  9. 9.
    Geschwind N, Behan P (1982) Left-handedness: association with immune disease, migraine, and developmental learning disorder. Proc Natl Acad Sci U S A 79:5097–5100PubMedGoogle Scholar
  10. 10.
    Morfit NS, Weekes NY (2001) Handedness and immune function. Brain Cogn 46:209–213PubMedGoogle Scholar
  11. 11.
    Coren S, Halpern DF (1991) left-handedness: a marker for decreased survival fitness. Psychol Bull 109:90–106CrossRefPubMedGoogle Scholar
  12. 12.
    Chyatte C, Smith V (1981) Brain asymmetry predicts suicide among navy alcohol abusers. Mil Med 146:277–278PubMedGoogle Scholar
  13. 13.
    Smith V, Chyatte C (1983) left-handed versus right-handed alcoholics: an examination of relapse patterns. J Stud Alcohol 44:553–555PubMedGoogle Scholar
  14. 14.
    Coren S, Searleman A, Porac C (1986) Rate of physical maturity and handedness. Dev Neuropsychol 2:17–23Google Scholar
  15. 15.
    Coren S (1989) Left-handedness and accident-related injury risk. Am J Public Health 79:1040–1041PubMedGoogle Scholar
  16. 16.
    Graham CJ (1995) Left-handedness as an injury risk factor in adolescents. J Adolesc Health 16:50–53CrossRefPubMedGoogle Scholar
  17. 17.
    Taras J (1995) Left hand dominance and hand trauma. J Hand Surg 20A:1043–1045Google Scholar
  18. 18.
    World Health Organization (1992) International statistical classification of diseases and related health problems, 10th rev, vol 1. World Health Organization, GenevaGoogle Scholar
  19. 19.
    Racxkowski D, Kalat JW (1974) Reliability and validity of some handedness questionnaire items. Neuropsychologia 12:43–47CrossRefPubMedGoogle Scholar
  20. 20.
    Annett M (2002) Human handedness, discrete types or continuous varieties. In: Annett M (ed) Handedness and brain symmetry: the right shift theory. Psychology Press, New York, pp 23–47Google Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2003

Authors and Affiliations

  • Crystal M. Luetters
    • 1
    Email author
  • Jennifer L. Kelsey
    • 2
  • Theresa H. M. Keegan
    • 2
  • Charles P. Quesenberry
    • 3
  • Stephen Sidney
    • 3
  1. 1.Division of GeriatricsUCLA School of MedicineLos AngelesUSA
  2. 2.Division of EpidemiologyStanford University School of MedicineStanfordUSA
  3. 3.Division of ResearchKaiser Permanente Medical Care ProgramOaklandUSA

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