Correlations between indentation modulus and mineral density in bone-fracture calluses

The mechanical properties of a healing bone fracture depend not only on the geometry of the fracture callus but also on the material properties of the callus tissues. Despite the biomechanical importance of callus tissues in restoring mechanical integrity to the injured bone, little is known about the material properties of these tissues and whether these properties can be estimated non-invasively. This study used nanoindentation to quantify the spatial variations in indentation modulus throughout the fracture callus and correlated the measurements of modulus with measurements of tissue mineral density (TMD) obtained from images from micro-computed tomography (µCT). Fracture calluses were harvested from rats 24 days following creation of a full-thickness, transverse osteotomy in the femoral mid-diaphysis. Calluses were imaged using µCT, and the average TMD and the median grayvalue (X-ray attenuation) of five, pre-defined volumes of interest (VOIs) in each callus were computed. Nanoindentation was then performed at multiple, regularly spaced locations across 150 µm-thick, sagittal sections of the calluses. The indentation modulus ranged from 0.51 to 1680 MPa throughout the callus, with the highest moduli in the center of the fracture gap and the lowest in the periphery of the gap (P < 0.05). TMD was also highest in the center of the gap (P < 0.05). An increasing trend in both modulus and TMD was observed in the regions of the callus adjacent to the periosteal surfaces of the cortex. While no correlation was found between the average indentation modulus in a given VOI and the median grayvalue of that VOI, the average indentation modulus and the average TMD were positively correlated (R = 0.70, P < 0.05). Together, these findings establish the spatial heterogeneity in the mechanical behavior of tissues in fracture calluses and indicate that the indentation modulus of these tissues can be estimated by non-invasive measurements of tissue mineralization.