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Left-handedness as a risk factor for fractures


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.

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  1. 1.

    Seddon BM, McManus IC (1991) The incidence of left-handedness: a meta-analysis. Unpublished manuscript, University College, London

    Google Scholar 

  2. 2.

    Geschwind N, Galaburda AM (1985) Cerebral lateralization: biological mechanisms, associations, and pathology (I, II, III). Arch Neurol 42:428–654

    CAS  PubMed  Google Scholar 

  3. 3.

    Searleman A, Coren S, Porac C (1989) Relationship between birth order, birth stress, and lateral preferences: a critical review. Psychol Bull 105:397–408

    Article  CAS  PubMed  Google 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 251–281

  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 140:361–367

    CAS  PubMed  Google Scholar 

  6. 6.

    Stellman S, Wynder E, DeRose D, Muscat J (1997) The epidemiology of left-handedness in a hospital population. Ann Epidemiol 7:167–171

    Article  CAS  PubMed  Google 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 31:503–515

    CAS  PubMed  Google Scholar 

  8. 8.

    Kim H, Yi S, San EI, Kim J (2001) Evidence for the psychological right-handedness hypothesis. Neuropsychology 15:510–515

    Article  CAS  PubMed  Google 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 79:5097–5100

    CAS  PubMed  Google Scholar 

  10. 10.

    Morfit NS, Weekes NY (2001) Handedness and immune function. Brain Cogn 46:209–213

    CAS  PubMed  Google Scholar 

  11. 11.

    Coren S, Halpern DF (1991) left-handedness: a marker for decreased survival fitness. Psychol Bull 109:90–106

    Article  CAS  PubMed  Google Scholar 

  12. 12.

    Chyatte C, Smith V (1981) Brain asymmetry predicts suicide among navy alcohol abusers. Mil Med 146:277–278

    CAS  PubMed  Google Scholar 

  13. 13.

    Smith V, Chyatte C (1983) left-handed versus right-handed alcoholics: an examination of relapse patterns. J Stud Alcohol 44:553–555

    CAS  PubMed  Google Scholar 

  14. 14.

    Coren S, Searleman A, Porac C (1986) Rate of physical maturity and handedness. Dev Neuropsychol 2:17–23

    Google Scholar 

  15. 15.

    Coren S (1989) Left-handedness and accident-related injury risk. Am J Public Health 79:1040–1041

    CAS  PubMed  Google Scholar 

  16. 16.

    Graham CJ (1995) Left-handedness as an injury risk factor in adolescents. J Adolesc Health 16:50–53

    Article  CAS  PubMed  Google Scholar 

  17. 17.

    Taras J (1995) Left hand dominance and hand trauma. J Hand Surg 20A:1043–1045

    Google Scholar 

  18. 18.

    World Health Organization (1992) International statistical classification of diseases and related health problems, 10th rev, vol 1. World Health Organization, Geneva

  19. 19.

    Racxkowski D, Kalat JW (1974) Reliability and validity of some handedness questionnaire items. Neuropsychologia 12:43–47

    Article  CAS  PubMed  Google 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 23–47

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Correspondence to Crystal M. Luetters.

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Luetters, C.M., Kelsey, J.L., Keegan, T.H.M. et al. Left-handedness as a risk factor for fractures. Osteoporos Int 14, 918–922 (2003).

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  • Ambidextrous
  • Fractures
  • Handedness
  • Humeral fractures