Fracture Repair in the Distal Radius in Post-Menopausal Women: A Follow-Up Two Years Post-Fracture Using HRpQCT

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Abstract

Fracture healing is characterized by an intense increase in modeling and remodeling of bone, which allows removal of the cast after a stable distal radius fracture within 3-5 weeks. However, at that time bone strength has not recovered yet. We studied the changes in BMD, micro-architecture and bone stiffness after a distal radius fracture during a two-year follow-up in comparison to the contra-lateral side, and the association between the two-year stiffness and baseline BMD, micro-architecture, and early changes in these parameters. The fractured side of fourteen post-menopausal women (mean age 64 +/- 8) with a conservatively treated distal radius fracture was scanned by HRpQCT at 1-2, 3-4, 6-8 and 12 weeks and two years post-fracture. The same region contra-laterally was scanned as well at the two-year visit. BMD, micro-architecture and stiffness parameters were determined and the fracture side was compared to the contra-lateral side using a linear mixed-effect model. Spearman's correlation was used to correlate the two-year bone stiffness with baseline BMD, micro-architecture, and early three-month changes in these parameters. Two years post-fracture, cortical and trabecular thickness and torsional and bending stiffness were significantly higher at the fractured side as compared to the non-fractured side (21%, 55%, 31% and 29%, respectively, p < 0.05), while BMD was similar. Two-year torsional and bending stiffness correlated significantly with baseline BMD and cortical perimeter (|rho|>/=0.63, p < 0.016), but not with early changes in bone parameters. Using HRpQCT, this study illustrates that fracture healing is not completed by the time the cast is removed. We showed that from six weeks to two years post-fracture large changes occur in BMD, micro-architecture and biomechanical parameters at the fractured side, which were fully recovered after two years in comparison to the non-fractured contra-lateral side. Interestingly, higher two-year torsional and bending stiffness were associated with lower BMD and higher cortical perimeter at baseline. This article is protected by copyright. All rights reserved.
Original languageEnglish
Pages (from-to)1114-1122
Number of pages9
JournalJournal of Bone and Mineral Research
Volume31
Issue number5
Early online date5 Jan 2016
DOIs
Publication statusPublished - May 2016

Keywords

  • FRACTURE REPAIR
  • DISTAL RADIUS
  • POSTMENOPAUSAL WOMEN
  • HRpQCT
  • QUANTITATIVE COMPUTED-TOMOGRAPHY
  • BONE-DENSITY
  • MICROARCHITECTURE
  • PRECISION
  • ACCURACY

Cite this

@article{d03d4ae8916c4141af6788bb39b02694,
title = "Fracture Repair in the Distal Radius in Post-Menopausal Women: A Follow-Up Two Years Post-Fracture Using HRpQCT",
abstract = "Fracture healing is characterized by an intense increase in modeling and remodeling of bone, which allows removal of the cast after a stable distal radius fracture within 3-5 weeks. However, at that time bone strength has not recovered yet. We studied the changes in BMD, micro-architecture and bone stiffness after a distal radius fracture during a two-year follow-up in comparison to the contra-lateral side, and the association between the two-year stiffness and baseline BMD, micro-architecture, and early changes in these parameters. The fractured side of fourteen post-menopausal women (mean age 64 +/- 8) with a conservatively treated distal radius fracture was scanned by HRpQCT at 1-2, 3-4, 6-8 and 12 weeks and two years post-fracture. The same region contra-laterally was scanned as well at the two-year visit. BMD, micro-architecture and stiffness parameters were determined and the fracture side was compared to the contra-lateral side using a linear mixed-effect model. Spearman's correlation was used to correlate the two-year bone stiffness with baseline BMD, micro-architecture, and early three-month changes in these parameters. Two years post-fracture, cortical and trabecular thickness and torsional and bending stiffness were significantly higher at the fractured side as compared to the non-fractured side (21{\%}, 55{\%}, 31{\%} and 29{\%}, respectively, p < 0.05), while BMD was similar. Two-year torsional and bending stiffness correlated significantly with baseline BMD and cortical perimeter (|rho|>/=0.63, p < 0.016), but not with early changes in bone parameters. Using HRpQCT, this study illustrates that fracture healing is not completed by the time the cast is removed. We showed that from six weeks to two years post-fracture large changes occur in BMD, micro-architecture and biomechanical parameters at the fractured side, which were fully recovered after two years in comparison to the non-fractured contra-lateral side. Interestingly, higher two-year torsional and bending stiffness were associated with lower BMD and higher cortical perimeter at baseline. This article is protected by copyright. All rights reserved.",
keywords = "FRACTURE REPAIR, DISTAL RADIUS, POSTMENOPAUSAL WOMEN, HRpQCT, QUANTITATIVE COMPUTED-TOMOGRAPHY, BONE-DENSITY, MICROARCHITECTURE, PRECISION, ACCURACY",
author = "{de Jong}, J. and F.L. Heyer and J.J. Arts and {Poeze - van Bokhoven}, Martijn and Andras Keszei and P.C. Willems and {van Rietbergen}, B. and P.P. Geusens and {van den Bergh}, J.P.",
year = "2016",
month = "5",
doi = "10.1002/jbmr.2766",
language = "English",
volume = "31",
pages = "1114--1122",
journal = "Journal of Bone and Mineral Research",
issn = "0884-0431",
publisher = "Wiley",
number = "5",

}

TY - JOUR

T1 - Fracture Repair in the Distal Radius in Post-Menopausal Women: A Follow-Up Two Years Post-Fracture Using HRpQCT

AU - de Jong, J.

AU - Heyer, F.L.

AU - Arts, J.J.

AU - Poeze - van Bokhoven, Martijn

AU - Keszei, Andras

AU - Willems, P.C.

AU - van Rietbergen, B.

AU - Geusens, P.P.

AU - van den Bergh, J.P.

PY - 2016/5

Y1 - 2016/5

N2 - Fracture healing is characterized by an intense increase in modeling and remodeling of bone, which allows removal of the cast after a stable distal radius fracture within 3-5 weeks. However, at that time bone strength has not recovered yet. We studied the changes in BMD, micro-architecture and bone stiffness after a distal radius fracture during a two-year follow-up in comparison to the contra-lateral side, and the association between the two-year stiffness and baseline BMD, micro-architecture, and early changes in these parameters. The fractured side of fourteen post-menopausal women (mean age 64 +/- 8) with a conservatively treated distal radius fracture was scanned by HRpQCT at 1-2, 3-4, 6-8 and 12 weeks and two years post-fracture. The same region contra-laterally was scanned as well at the two-year visit. BMD, micro-architecture and stiffness parameters were determined and the fracture side was compared to the contra-lateral side using a linear mixed-effect model. Spearman's correlation was used to correlate the two-year bone stiffness with baseline BMD, micro-architecture, and early three-month changes in these parameters. Two years post-fracture, cortical and trabecular thickness and torsional and bending stiffness were significantly higher at the fractured side as compared to the non-fractured side (21%, 55%, 31% and 29%, respectively, p < 0.05), while BMD was similar. Two-year torsional and bending stiffness correlated significantly with baseline BMD and cortical perimeter (|rho|>/=0.63, p < 0.016), but not with early changes in bone parameters. Using HRpQCT, this study illustrates that fracture healing is not completed by the time the cast is removed. We showed that from six weeks to two years post-fracture large changes occur in BMD, micro-architecture and biomechanical parameters at the fractured side, which were fully recovered after two years in comparison to the non-fractured contra-lateral side. Interestingly, higher two-year torsional and bending stiffness were associated with lower BMD and higher cortical perimeter at baseline. This article is protected by copyright. All rights reserved.

AB - Fracture healing is characterized by an intense increase in modeling and remodeling of bone, which allows removal of the cast after a stable distal radius fracture within 3-5 weeks. However, at that time bone strength has not recovered yet. We studied the changes in BMD, micro-architecture and bone stiffness after a distal radius fracture during a two-year follow-up in comparison to the contra-lateral side, and the association between the two-year stiffness and baseline BMD, micro-architecture, and early changes in these parameters. The fractured side of fourteen post-menopausal women (mean age 64 +/- 8) with a conservatively treated distal radius fracture was scanned by HRpQCT at 1-2, 3-4, 6-8 and 12 weeks and two years post-fracture. The same region contra-laterally was scanned as well at the two-year visit. BMD, micro-architecture and stiffness parameters were determined and the fracture side was compared to the contra-lateral side using a linear mixed-effect model. Spearman's correlation was used to correlate the two-year bone stiffness with baseline BMD, micro-architecture, and early three-month changes in these parameters. Two years post-fracture, cortical and trabecular thickness and torsional and bending stiffness were significantly higher at the fractured side as compared to the non-fractured side (21%, 55%, 31% and 29%, respectively, p < 0.05), while BMD was similar. Two-year torsional and bending stiffness correlated significantly with baseline BMD and cortical perimeter (|rho|>/=0.63, p < 0.016), but not with early changes in bone parameters. Using HRpQCT, this study illustrates that fracture healing is not completed by the time the cast is removed. We showed that from six weeks to two years post-fracture large changes occur in BMD, micro-architecture and biomechanical parameters at the fractured side, which were fully recovered after two years in comparison to the non-fractured contra-lateral side. Interestingly, higher two-year torsional and bending stiffness were associated with lower BMD and higher cortical perimeter at baseline. This article is protected by copyright. All rights reserved.

KW - FRACTURE REPAIR

KW - DISTAL RADIUS

KW - POSTMENOPAUSAL WOMEN

KW - HRpQCT

KW - QUANTITATIVE COMPUTED-TOMOGRAPHY

KW - BONE-DENSITY

KW - MICROARCHITECTURE

KW - PRECISION

KW - ACCURACY

U2 - 10.1002/jbmr.2766

DO - 10.1002/jbmr.2766

M3 - Article

VL - 31

SP - 1114

EP - 1122

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 0884-0431

IS - 5

ER -