Predicting experimentally-derived failure load at the distal radius using finite element modelling based on peripheral quantitative computed tomography cross-sections (pQCT-FE): A validation study.

Dual energy X-ray absorptiometry, the current clinical criterion method for osteoporosis diagnosis, has limitations in identifying individuals with increased fracture risk, especially at the distal radius. Peripheral quantitative computed tomography (pQCT) can provide volumetric bone density data, as well as information on bone geometry, which makes it possible to establish finite element (FE) models of the distal radius from which bone strength and stiffness can be calculated. In this study, we compared experimental mechanical failure load data of the forearm with pQCT- based FE (pQCT-FE) modelling properties. Sixteen cadaveric forearm specimens were experimentally loaded until failure. Estimated stiffness and strength variables of compression, shear, bending and torsion were calculated from pQCT-FE modelling of single cross-sections of 0.2 × 0.2 × 2.4 mm of the radius pQCT image. A moderate-to-strong coefficient of determination (r) was observed between experimental failure load and pQCT-FE variables. The highest r was observed for bending stiffness (r = 0.83). This study validates the use of pQCT-FE in the assessment of distal radius bone strength for future studies.