The prediction of cyclic proximal humerus fracture fixation failure by various bone density measures

Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society
Peter VargaMarkus Windolf

Abstract

Fixation of osteoporotic proximal humerus fractures has remained challenging, but may be improved by careful pre-operative planning. The aim of this study was to investigate how well the failure of locking plate fixation of osteoporotic proximal humerus fractures can be predicted by bone density measures assessed with currently available clinical imaging (realistic case) and a higher resolution and quality modality (theoretical best-case). Various density measures were correlated to experimentally assessed number of cycles to construct failure of plated unstable low-density proximal humerus fractures (N = 18). The influence of density evaluation technique was investigated by comparing local (peri-implant) versus global evaluation regions; HR-pQCT-based versus clinical QCT-based image data; ipsilateral versus contralateral side; and bone mineral content (BMC) versus bone mineral density (BMD). All investigated density measures were significantly correlated with the experimental cycles to failure. The best performing clinically feasible parameter was the QCT-based BMC of the contralateral articular cap region, providing significantly better correlation (R2 = 0.53) compared to a previously proposed clinical density measure (R2 = 0...Continue Reading

References

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Citations

Jul 28, 2019·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Daniel CiricPeter Varga
Jan 9, 2020·Journal of Biomechanical Engineering·Maryam TiltonGregory S Lewis
Jan 26, 2021·Geriatric Orthopaedic Surgery & Rehabilitation·Anil TaskesenYüksel Uğur Yaradılmış
Feb 2, 2021·Journal of the Mechanical Behavior of Biomedical Materials·Vasiliki C PanagiotopoulouPeter Varga
Mar 10, 2019·The Orthopedic Clinics of North America·Michael A Stone, Surena Namdari

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