Institute of Lightweight Design and Structural Biomechanics, Vienna University of Technology, Gußhausstraße 27-29, A-1040 Vienna, Austria.
Bone. 2010 Nov;47(5):982-8. doi: 10.1016/j.bone.2010.08.002. Epub 2010 Aug 6.
The remarkable performances of high-resolution peripheral quantitative computed tomography (HR-pQCT) make the distal radius a favorable site for early diagnosis of osteoporosis and improved Colles' fracture risk assessment. The goal of this study was to investigate if the HR-pQCT-based micro finite element (μFE) method applied on specific sections of the distal radius provides improved predictions of Colles' fracture load in vitro compared to bone mineral content (BMC), bone mineral density (BMD), or histomorphometric indices. HR-pQCT based BMC, BMD, histomorphometric parameters, and μFE models of 9-mm-thick bone sections were used to predict fracture load of 21 distal radii assessed in an experimental model of Colles' fracture reported in a previous study. The analysis was performed on two bone sections: a standard one recommended by the HR-pQCT manufacturer and a second one defined just proximal to the distal subchondral plate. For most of the investigated parameters, significant differences were found between the values of the two sections. Correlations with experimental fracture load and strength were higher in the most distal section, and the difference was statistically significant for μFE strength. Furthermore, the most distal section was computed to have significantly lower ultimate force and strength by 13% and 35%, respectively, than the standard section. BMC provided a better estimation of Colles' fracture load (R(2)=0.942) than aBMD or any other histomorphometric indices. The best prediction was achieved with μFE analyses of the most distal slice (R(2)=0.962), which provided quantitatively correct ultimate forces.
高分辨率外周定量计算机断层扫描（HR-pQCT）的出色表现使得桡骨远端成为骨质疏松症早期诊断和改善 Colles 骨折风险评估的理想部位。本研究旨在探讨 HR-pQCT 基于微有限元（μFE）方法在桡骨远端特定节段的应用是否能比骨矿物质含量（BMC）、骨矿物质密度（BMD）或组织形态计量学指数更好地预测 Colles 骨折的体外载荷。使用 HR-pQCT 基于 BMC、BMD、组织形态计量学参数和μFE 模型的 9 毫米厚骨节段，预测了之前研究中报道的 Colles 骨折实验模型中 21 个桡骨远端的骨折载荷。分析在两个骨节段上进行：一个是 HR-pQCT 制造商推荐的标准节段，另一个是在远端软骨下板近端定义的第二个节段。对于大多数研究的参数，两个节段之间的值存在显著差异。与实验骨折载荷和强度的相关性在最远端节段更高，μFE 强度的差异具有统计学意义。此外，与标准节段相比，最远端节段的最终力和强度分别低 13%和 35%。BMC 对 Colles 骨折载荷的估计优于 aBMD 或任何其他组织形态计量学指数（R(2)=0.942）。使用最远端切片的 μFE 分析（R(2)=0.962）提供了最好的预测，其提供了定量正确的最终力。
