The novel application of high resolution peripheral quantitative ct imaging in distal radius and scaphoid fractures

In this thesis the association of patient characteristics, bone mineral density, BMD (measured by DXA), bone microarchitecture and calculated bone strength (measured by HR-pQCT) with the pattern complexity and secondary displacement of distal radius fractures was investigated. This thesis demonstrated that age and male gender were independently associated with pattern complexity of distal radius fractures. The most important determinant for secondary displacement of a distal radius fracture was primary reduction. Lower total and cortical volumetric bone mineral density and lower cortical thickness at the distal radius were independently associated with secondary displacement of a distal radius fracture. Subsequently, the novel application of HR-pQCT for detection of scaphoid fractures was studied. HR-pQCT scanning of the scaphoid bone is feasible and reliable in patients with a clinically suspected scaphoid fracture when using a cast with thumb part. This thesis concludes that scaphoid fracture detection with HR-pQCT is superior compared to conventional CT and that HR-pQCT could be a promising novel application for the detection of scaphoid fractures.