Three-Dimensional Characterization of Trabecular Bone Mineral Densityof the Distal Radius Utilizing Quantitative Computed Tomography

摘要

Background: Distal radius (DR) fractures demonstrate patterns ofpredictable fragments. Bone mineral density (BMD) measurements of these regionsof interest (ROIs) may guide more precise treatment. Methods:Computed tomography (CT) scans of the DR of 42 healthy volunteers (23 female)were analyzed using quantitative CT software, measuring BMD within trabecularbone. Seven ROIs were described by alignment with the distal (volar ulnar distal[VUD], dorsal ulnar distal [DUD], volar radial distal [VRD], and dorsal radialdistal [DRD]) or proximal (middle ulnar proximal [MUP], middle proximal [MP],and middle radial proximal [MRP]) sigmoid notch. Additional ROIs were the radialstyloid (RS) and metadiaphysis (MD). A general estimation equation assessedsubject’s BMDs with predictive factors of gender, ROI, and age. The interactionbetween gender, ROI, and age was included in the model to allow for differencesin ROI to vary with gender and/or age. Results: Comparing ROIswithin the same gender and, separately, within the same age group revealedsignificantly higher BMD adjacent to the radioulnar and radiocarpal joints. Maleand female individuals aged ≥50 years (mean: 172.7 mg/cm3 ± 6.1) hadsignificantly lower BMD than those aged <50 years (mean: 202.7mg/cm3 ± 5.8) when all ROIs were considered. Males had highermean BMD at each ROI compared with females; these differences were significantin 5 of the 9 ROIs: VUD, DUD, DRD, RS, MUP. Conclusions: TrabecularBMD of the DR is highest adjacent to the radioulnar and radiocarpal joints.Female patients and those ≥50 years have lower trabecular BMD.