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Decrease in bone mineral density and muscle mass after femoral neck fracture. A quantitative computed tomography

G Neander1, P Adolphson, M Hedström

  • 1Department of Orthopedics, Danderyd Hospital, Sweden.

Acta Orthopaedica Scandinavica
|December 31, 1997
PubMed
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This study found significant bone loss in the fractured leg and even the uninjured leg 6 months after femoral neck fracture surgery. Cancellous bone is more susceptible to post-traumatic osteopenia.

Area of Science:

  • Orthopedics
  • Radiology
  • Bone Metabolism

Background:

  • Displaced femoral neck fractures often require surgical intervention (osteosynthesis).
  • The long-term effects of such fractures and surgery on bone mineral density (BMD) and muscle volume are not fully understood.
  • Quantitative computed tomography (QCT) offers a precise method for assessing bone and muscle parameters.

Purpose of the Study:

  • To longitudinally assess changes in bone mineral density (BMD), cortical bone volume, bone mass, and muscle volume after osteosynthesis for displaced femoral neck fractures.
  • To investigate the sensitivity of different bone compartments (cortical vs. cancellous) to post-traumatic osteopenia.
  • To differentiate between post-traumatic effects and potential overuse phenomena on bone and muscle.

Main Methods:

Related Experiment Videos

  • Prospective, longitudinal quantitative computed tomography (QCT) study.
  • Involved 25 patients undergoing osteosynthesis for displaced femoral neck fractures.
  • Scans of both legs were performed within 3 days post-fracture, and at 3 and 6 months post-operation.

Main Results:

  • Significant reductions in BMD observed: 11% in the distal femur and 19% in the proximal tibia on the fractured side.
  • A 7% reduction in BMD was noted in the proximal tibia of the uninjured side at 6 months.
  • No changes in cortical bone mass were found; however, thigh muscles showed a 9% loss on the fractured side and a 12% gain on the uninjured side.

Conclusions:

  • Cancellous bone is more sensitive to post-traumatic osteopenia than cortical bone following femoral neck fracture.
  • Observed bone loss in both fractured and uninjured legs suggests a significant systemic post-traumatic effect.
  • The bone loss is primarily attributed to post-traumatic effects, outweighing compensatory muscle overuse in the uninjured limb.