LUMC Center for Bone Quality, Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands.
Center for Bone Quality, Department of Trauma Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Osteoporos Int. 2022 Jul;33(7):1511-1519. doi: 10.1007/s00198-022-06368-0. Epub 2022 Mar 21.
Bone material properties were assessed using impact microindentation in patients with high-energy trauma fractures. Compared to patients with low-energy trauma fractures, bone material strength index was significantly higher in patients with high-energy trauma fractures, and did not differ between patients with osteopenia and those with osteoporosis within each trauma group.
Impact microindentation (IMI) is a technique to assess tissue-level properties of bone at the tibia. Bone material strength index (BMSi), measured by IMI, is decreased in patients with low-energy trauma fractures, independently of areal bone mineral density (aBMD), but there is no information about BMSi in patients with high-energy trauma fractures. In the present study, we evaluated tissue-level properties of bone with IMI in patients with high-energy trauma fractures.
BMSi was measured 3.0 months (IQR 2.0-5.8) after the fracture in 40 patients with high-energy trauma and 40 age- and gender-matched controls with low-energy trauma fractures using the OsteoProbe® device.
Mean age of high- and low-energy trauma patients was 57.7 ± 9.1 and 57.2 ± 7.7 years, respectively (p = 0.78). Fracture types were comparable in high- vs low-energy trauma patients. Lumbar spine (LS)-aBMD, but not femoral neck (FN)-aBMD, was higher in high- than in low-energy trauma patients (LS 0.96 ± 0.13 vs 0.89 ± 0.13 g/cm, p = 0.02; FN 0.75 ± 0.09 vs 0.72 ± 0.09 g/cm, p = 0.09). BMSi was significantly higher in high- than in low-energy trauma patients (84.4 ± 5.0 vs 78.0 ± 4.6, p = 0.001), also after adjusting for aBMD (p = 0.003). In addition, BMSi did not differ between patients with osteopenia and those with osteoporosis within each trauma group.
Our data demonstrate that BMSi and LS-aBMD, but not FN-aBMD, are significantly higher in high-energy trauma patients compared to matched controls with similar fractures from low-energy trauma. Further studies of non-osteoporotic patients with high-energy trauma fracture with measurements of BMSi are warranted to determine whether IMI might help in identifying those with reduced bone strength.
使用冲击微压痕评估高能创伤骨折患者的骨材料特性。与低能创伤骨折患者相比，高能创伤骨折患者的骨材料强度指数明显更高，且在每个创伤组中，骨质疏松症患者与骨量减少患者之间的骨材料强度指数无差异。
冲击微压痕（IMI）是一种评估胫骨组织水平骨特性的技术。通过 IMI 测量的骨材料强度指数（BMSi）在低能创伤骨折患者中降低，且与面积骨密度（aBMD）独立相关，但高能创伤骨折患者的 BMSi 信息尚未可知。在本研究中，我们使用 OsteoProbe®设备评估了高能创伤骨折患者的 IMI 组织水平骨特性。
在骨折后 3.0 个月（IQR 2.0-5.8）时，对 40 例高能创伤患者和 40 例年龄和性别匹配的低能创伤骨折患者进行 BMSi 测量。
高能和低能创伤患者的平均年龄分别为 57.7±9.1 岁和 57.2±7.7 岁（p=0.78）。高能与低能创伤患者的骨折类型相当。高能创伤患者的腰椎（LS）-aBMD 高于低能创伤患者，而股骨颈（FN）-aBMD 则相反（LS 0.96±0.13 vs 0.89±0.13 g/cm，p=0.02；FN 0.75±0.09 vs 0.72±0.09 g/cm，p=0.09）。高能创伤患者的 BMSi 明显高于低能创伤患者（84.4±5.0 vs 78.0±4.6，p=0.001），即使在调整了 aBMD 后（p=0.003）也是如此。此外，在每个创伤组中，骨质疏松症患者与骨量减少患者之间的 BMSi 无差异。
我们的数据表明，与具有相似低能创伤骨折的匹配对照组相比，高能创伤患者的 BMSi 和 LS-aBMD 明显更高，而 FN-aBMD 则不然。需要对高能创伤骨折且无骨质疏松症的非骨质疏松症患者进行更多的 BMSi 测量研究，以确定 IMI 是否有助于识别那些骨强度降低的患者。
