Proximal femoral bone density and its correlation to fracture load and hip-screw penetration load

The bone mineral density of 22 random, fresh proximal human femora was estimated by roentgenography using the Singh index (SI) and measured using a regional bone mineral density computed tomographic protocol. Uniaxial compression was used to produce an impacted subcapital fracture. The femoral heads then were isolated and mounted on a sliding screw plate compression device and loaded to failure in a push-out or hip-screw penetration mode. Wide intraobserver variation, poor reproducibility, and poor prediction of the experimental fracture properties of the proximal femur were noted for SI values. Regional bone mineral density provided a reliable estimate of both the gross fracture loads and hip-screw penetration loads. In addition, there was a high correlation between trabecular density and the experimental fracture properties of the proximal femur. Therefore, The validity of the SI as an indicator of the mechanical properties of the proximal femur should be reconsidered.