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Title: | Association of secondary displacement of distal radius fractures with cortical bone quality at the distal radius | Authors: | Daniels, A. M. Janzing, H. M. J. Wyers, C.E. van Rietbergen, B. Vranken, L. Van der Velde, R. Y. GEUSENS, Piet Kaarsemaker, S. Poeze, M. VAN DEN BERGH, Joop |
Issue Date: | 2021 | Publisher: | SPRINGER | Source: | Archives of orthopaedic and trauma surgery (Print), 141 (11), p. 1909-1918 | Abstract: | Introduction The aim of this study was to investigate the associations of patient characteristics, bone mineral density (BMD), bone microarchitecture and calculated bone strength with secondary displacement of a DRF based on radiographic alignment parameters. Materials and methods Dorsal angulation, radial inclination and ulnar variance were assessed on conventional radiographs of a cohort of 251 patients, 38 men and 213 women, to determine the anatomic position of the DRF at presentation (primary position) and during follow-up. Secondary fracture displacement was assessed in the non-operatively treated patients (N = 154) with an acceptable position, preceded (N = 97) or not preceded (N = 57) by primary reduction (baseline position). Additionally, bone microarchitecture and calculated bone strength at the contralateral distal radius and tibia were assessed by HR-pQCT in a subset of, respectively, 63 and 71 patients. Outcome Characteristics of patients with and without secondary fracture displacement did not differ. In the model with adjustment for primary reduction [OR 22.00 (2.27-212.86), p = 0.008], total [OR 0.16 (95% CI 0.04-0.68), p = 0.013] and cortical [OR 0.19 (95% CI 0.05-0.80], p = 0.024] volumetric BMD (vBMD) and cortical thickness [OR 0.13 (95% CI 0.02-0.74), p = 0.021] at the distal radius were associated with secondary DRF displacement. No associations were found for other patient characteristics, such as age gender, BMD or prevalent vertebral fractures. Conclusions In conclusion, our study indicates that besides primary reduction, cortical bone quality may be important for the risk of secondary displacement of DRFs. | Notes: | Daniels, AM (corresponding author), VieCuri Med Ctr, Dept Surg, Tegelseweg 210, NL-5912 BL Venlo, Netherlands.; Daniels, AM (corresponding author), Maastricht Univ, NUTRIM Sch Nutr & Translat Res Metab, Univ Singel 40, NL-6229 ER Maastricht, Netherlands. adaniels@viecuri.nl |
Other: | Daniels, AM (corresponding author), VieCuri Med Ctr, Dept Surg, Tegelseweg 210, NL-5912 BL Venlo, Netherlands ; Maastricht Univ, NUTRIM Sch Nutr & Translat Res Metab, Univ Singel 40, NL-6229 ER Maastricht, Netherlands. adaniels@viecuri.nl | Keywords: | Distal radius fracture (DRF);Fracture displacement;High-resolution peripheral quantitative CT (HR-pQCT);Bone microarchitecture and strength;Primary reduction | Document URI: | http://hdl.handle.net/1942/32896 | ISSN: | 0936-8051 | e-ISSN: | 1434-3916 | DOI: | 10.1007/s00402-020-03658-2 | ISI #: | WOS:000583154800001 | Rights: | The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2021 |
Appears in Collections: | Research publications |
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