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Cortical and trabecular bone contribute strength to the osteopenic distal radius
J A Spadaro1, F W Werner, R A Brenner
1Department of Orthopedic Surgery, State University of New York, Syracuse.
Summary
Distal radius fractures are common in older women. This study found the cortical shell significantly contributes to wrist bone strength, with bone mineral content being the best predictor of fracture risk.
Area of Science:
- Orthopedics
- Biomechanics
- Gerontology
Background:
- Distal radius fractures are prevalent, particularly in postmenopausal women, with incidence increasing with age.
- Understanding risk factors for distal radius fractures is crucial for prediction and treatment.
- The study focused on the roles of cortical and trabecular bone in distal radius strength.
Purpose of the Study:
- To determine the relative contributions of cortical and trabecular bone to distal radius strength.
- To identify the most effective radiographic indicators of bone strength in the distal radius.
Main Methods:
- Analysis of 21 fresh cadaver forearms (median age 75 years).
- Bone mineral content (BMC), density (BMC/W), and cross-sectional properties measured using single photon absorptiometry and quantitative computed tomography.
- Mechanical testing to determine ultimate force and energy to fracture.
Main Results:
- Cortical cross-sectional area and moment of inertia were better strength correlates than trabecular measures at the metaphyseal site.
- Trabecular bone density was a stronger correlate of strength than cortical density.
- Bone mineral content (BMC) and BMC/W at distal or proximal sites were the best overall correlates of strength.
Conclusions:
- The cortical shell of the distal radius contributes more to mechanical strength than previously recognized.
- Trabecular density and overall bone mineral content are key indicators for assessing distal radius strength and fracture risk.