Measurement of Trabecular Bone Microstructure Does Not Improve Prediction of Mechanical Failure Loads at the Distal Radius Compared with Bone Mass Alone
Measurement of Trabecular Bone Microstructure Does Not Improve Prediction of Mechanical Failure Loads at the Distal Radius Compared with Bone Mass Alone
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DOI：
10.1007/s00223-008-9172-z
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发表时间：
2008-10-01
影响因子：
4.2
通讯作者：
Eckstein, F.
中科院分区：
文献类型：
--
作者：
Lochmueller, E.-M.;Kristin, J.;Eckstein, F.
骨量预测了骨衰竭强度的高变异性，但已知在有和没有骨折的受试者中存在重叠。在这里，我们验证了一种假设，即与单独的骨量相比，用微型计算机断层扫描（mu CT）确定的骨小梁微观结构可以改善前臂远端实验破坏负荷的预测。对130例人体标本的右前臂和左桡骨远端进行了检查。采用外周双能x线吸收仪（DXA）测定骨密度（BMD）。这些标本经过机械测试，直到在跌倒状态下失效，手、肘部、韧带和肌腱完好无损。对侧桡骨远端干骺端靠近软骨下骨板取圆柱形骨标本，用mu CT扫描。在分析总样本时，桡骨远端BMD与机械失效载荷的相关性为r = 0.82。在剔除21例试验后无明显骨折影像学征象的标本后，相关性提高到r = 0.85。当仅纳入79例典型骨折标本时，相关系数r = 0.82。试件的微观结构参数与破坏载荷呈相关关系
Bone mass predicts a high proportion of variability in bone failure strength but is known to overlap among subjects with and without fractures. Here, we tested the hypothesis that trabecular bone microstructure, determined with micro-computed tomography (mu CT), can improve the prediction of experimental failure loads in the distal forearm compared with bone mass alone. The right forearm and left distal radius of 130 human specimens were examined. Bone mineral density (BMD) was measured with peripheral dual energy X-ray absorptiometry (DXA). The specimens were mechanically tested to failure in a fall configuration, with the hand, elbow, ligaments, and tendons intact. Cylindrical bone samples from the metaphysis of the contralateral distal radius were obtained adjacent to the subchondral bone plate and scanned with mu CT. When analyzing the total sample, BMD of the distal radius displayed a correlation of r = 0.82 with mechanical failure loads. After excluding 21 specimens with no obvious radiological sign of fracture after the test, the correlation increased to r = 0.85. When only including 79 specimens with loco typico fractures, the correlation was r = 0.82. The microstructural parameters showed correlation coefficients with the failure loads of