Bone microarchitecture and distal radius fracture pattern complexity

Daniels, Anne M.; Theelen, Luuk M. A.; Wyers, Caroline E.; Janzing, Heinrich M. J.; van Rietbergen, Bert; Vranken, Lisanne; van der Velde, Robert Y.; Geusens, Piet P. M. M.; Kaarsemaker, Sjoerd; Poeze, Martijn; vanden Bergh, Joop P.

Affiliations

¹Department of Surgery, VieCuri Medical Centre, Venlo, The Netherlands

²NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands

³Department of Orthopaedic Surgery, VieCuri Medical Centre, Venlo, The Netherlands

⁴Department of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands

⁵Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands

⁶Department of Biomedical Engineering, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, The Netherlands

⁷Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands

⁸Faculty of Medicine, Division of Internal Medicine, Hasselt University, Hasselt, Belgium

⁹Department of Surgery, Division of Traumasurgery, Maastricht University Medical Centre, Maastricht, The Netherlands

Abstract and keywords

Distal radius fractures (DRFs) occur in various complexity patterns among patients differing in age, gender, and bone mineral density (BMD). Our aim was to investigate the association of patient characteristics, BMD, bone microarchitecture, and bone strength with the pattern complexity of DRFs. In this study, 251 patients aged 50–90 years with a radiologically confirmed DRF who attended the Fracture Liaison Service of VieCuri Medical Centre, the Netherlands, between November 2013 and June 2016 were included. In all patients fracture risk factors and underling metabolic disorders were evaluated and BMD measurement with vertebral fractures assessment by dual‐energy X‐ray absorptiometry was performed. Radiographs of all DRFs were reviewed by two independent investigators to assess fracture pattern complexity according to the AO/OTA classification in extra‐articular (A), partially articular (B), and complete articular (C) fractures. For this study, patients with A and C fractures were compared. Seventy‐one patients were additionally assessed by high‐resolution peripheral quantitative computed tomography. Compared to group A, mean age, the proportion of males, and current smokers were higher in group C, but BMD and prevalent vertebral fractures were not different. In univariate analyses, age, male gender, trabecular area, volumetric BMD (vBMD), and stiffness were associated with type C fractures. In multivariate analyses, only male gender (odds ratio (OR) 8.48 95% confidence interval (CI) 1.75–41.18, p = 0.008]) and age (OR 1.11 [95% CI 1.03–1.19, p = 0.007]) were significantly associated with DRF pattern complexity. In conclusion, our data demonstrate that age and gender, but not body mass index, BMD, bone microarchitecture, or strength were associated with pattern complexity of DRFs.

Keywords: distal radius fracture (DRF); high‐resolution peripheral quantitative CT (HR‐pQCT); micro‐finite element analyses (micro‐ FEA); fracture pattern complexity; bone microstructure

Links

DOI: 10.1002/jor.24306

PubMed: 30977554

WoS: 000501249400003

History

Received: 2018-12-27

Accepted: 2019-03-27

Online: 2019-04-24

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Cited By (1)

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2023	Schlickewei C, Schweizer C, Püschel K, Ondruschka B, Kleinertz H, Barg A, Rolvien T, Stürznickel J. Age-, sex-, and subregion-specific properties of distal fibular microarchitecture and strength: an ex vivo HR-pQCT study. J Orthop Res. February 2023;41(2):355-363.