Stowers Jered M, Black Alexandra T, Kavanagh Amber M, Mata Karla De La, Eshetu Tefera
Fellowship Trained Foot and Ankle Surgeon, Foot and Ankle Specialists of Central Ohio, Columbus, OH.
Fellowship Trained Foot and Ankle Surgeon, Foot and Ankle Specialists of Central Ohio, Columbus, OH.
J Foot Ankle Surg. 2023 Jan-Feb;62(1):80-84. doi: 10.1053/j.jfas.2022.05.002. Epub 2022 May 13.
Understanding bone mineral density and its effects on patient outcomes is a useful tool for lower extremity surgeons. Historically, dual-energy X-ray absorptiometry scans have been the gold standard for quantifying bone mineral density. In this study, we look at an indirect way to measure bone mineral density using Hounsfield units on computed tomography. The aim of this study is to establish normal physiological Hounsfield ranges in specific bones of the foot by analyzing Hounsfield unit measurements and determining associated factors. We hypothesize that there will be a difference in density based on age, sex, and anatomic location. Patient data from January 2010 to January 2020 were retrospectively analyzed from 2 institutions. Nine anatomic locations (calcaneus, talar body, talar head, navicular, cuboid, medial cuneiform, head of first and fifth metatarsal, and base of first proximal phalanx) were measured for bone mineral density averages. In total, 137 patients were evaluated (71 males, 66 females) with an average age of 54 years. Significant differences in density were found between the 9 anatomic locations. Age was confirmed to be a significant covariate with inverse relation to Hounsfield units, p < .001. There were no density differences between sexes at any of the locations, except the talar head, p < .001. This is the first study to our knowledge to establish normal physiological ranges of bone density on computed tomography for specific anatomic locations of the foot. This quantitative approach to bone density and the established effect of age, sex, and location is pivotal for diagnostic and preoperative planning.
了解骨密度及其对患者预后的影响，对于下肢外科医生来说是一项有用的工具。从历史上看，双能X线吸收法扫描一直是量化骨密度的金标准。在本研究中，我们探讨了一种利用计算机断层扫描上的亨氏单位间接测量骨密度的方法。本研究的目的是通过分析亨氏单位测量值并确定相关因素，来确定足部特定骨骼的正常生理亨氏范围。我们假设基于年龄、性别和解剖位置，骨密度会存在差异。对2家机构2010年1月至2020年1月的患者数据进行了回顾性分析。测量了9个解剖位置（跟骨、距骨体、距骨头、舟骨、骰骨、内侧楔骨、第一和第五跖骨头以及第一近端趾骨基部）的骨密度平均值。总共评估了137例患者（71例男性，66例女性），平均年龄为54岁。发现9个解剖位置之间的密度存在显著差异。年龄被确认为与亨氏单位呈负相关的显著协变量，p < 0.001。除距骨头外，各位置的性别之间均无密度差异，p < 0.001。据我们所知，这是第一项针对足部特定解剖位置在计算机断层扫描上建立骨密度正常生理范围的研究。这种骨密度定量方法以及已确定的年龄、性别和位置的影响，对于诊断和术前规划至关重要。
