Summary
The purpose of this investigation was to determine the cross-sectional geometry of the radius in female and male cadaveric specimens using dual-energy X-ray absorptiometry (DXA), to measure the accuracy of this technique compared with a digitizing procedure, and to measure the correlation between these DXA-based geometric variables and the load required to produce a forearm fracture. Paired intact forearms were scanned at a distal site and at a site approximately 30% of the forearm length from the distal end. The cross-sectional area and the moments of inertia of two sections at 10 and 30% of the forearm length were computed from the X-ray attenuation data. One member of each pair was then sectioned at the 30% location, which is mostly cortical bone, and the section was traced on a digitizing pad. The other forearm was loaded to failure in a servohydraulic materials test system. The DXA-based area and moment of inertia at 30% correlated significantly with the digitized results (r2=0.93 for area; r2=0.95 for moment; P<0.001). The conventional bone mineral density from DXA did not associate significantly with failure load, but the minimum moment of inertia and the cross-sectional area at 10% correlated in a strong and significant manner with the forearm fracture force (r2=0.67 for area; r2=0.66 for moment; P<0.001). The determination of radial bone cross-sectional geometry, therefore, should have better discriminatory capabilities than bone mineral density in studies of bone fragility and fracture risk.
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References
Melton LJ III (1988) Epidemiology of fractures. In: Riggs BL, Melton LJ III (eds) Osteoporosis: etiology, diagnosis, and management. New York, Raven Press, pp 133–154
Melton LJ, Kan SH, Frye MA, Wahner HW, O'Fallen WM, Riggs BL (1989) Epidemiology of vertebral fractures in women. Am J Epidemiol 129:1000–1011
Owen RA, Melton LJ III, Johnson KA, Ilstrup DM, Riggs BL (1982) Incidence of Colles' fracture in a North American community. Am J Public Health 72:605–607
Genant HK, Block JE, Steiger P, Glueer CC, Ettinger B, Harris ST (1989) Appropriate use of bone densitometry. Radiology 170:817–822
Mazess RB (1990) Bone densitometry of the axial skeleton. Orthop Clin N Am 21:51–63
Wahner HW (1989) Measurements of bone mass and bone density. Endocrinol Metab Clin N Am 18:995–1013
Lotz JC, Hayes WC (1990) Estimates of hip fracture risk from falls using quantitative computed tomography. J Bone Joint Surg [Am] 72:689–700
Myers ER, Hecker AT, Rooks DS, Hayes WC (1992) Correlations of the failure load of the femur with densitometric and geometric properties from QDR. Trans 38th ORS, 17:115
Beck TJ, Ruff CB, Warden KE, Scott WW, Rao GU (1990) Predicting femoral neck strength from bone mineral data. Invest Radiol 25:6–18
Sartoris DJ, Sommer FG, Kosek J, Gies A, Carter D (1985) Dual-energy projection radiography in the evaluation of femoral neck strength, density, and mineralization. Invest Radiol 20: 476–485
Dalen N, Hellstrom LG, Jacobson B (1976) Bone mineral content and mechanical strength of the femoral neck. Acta Orthop Scand 47:503–508
Leichter I, Margulies JY, Weinreb A, Mizrahi J, Robin GC, Conforty B, Makin M, Bloch B (1982) The relationship between bone density, mineral content, and mechanical strength in the femoral neck. Clin Orthop 163:272–281
McBroom RJ, Hayes WC, Edwards WT, Goldberg RP, White AA III (1985) Prediction of vertebral body compressive fracture using quantitative computed tomography. J Bone Joint Surg [AM] 67:1206–1214
Mosekilde L, Bentzen SM, Ortoft G, Jorgensen J (1989) The predictive value of quantitative computed tomography for vertebral body compressive strength and ash density. Bone 10:465–470
Myers ER, Sebeny EA, Hecker AT, Corcoran TA, Hipp JA, Greenspan SL, Hayes WC (1991) Correlations between photon absorption properties and failure load of the distal radius in vitro. Calcif Tissue Int 49:292–297
Martin BR, Burr DB (1984) Non-invasive measurement of long bone cross-sectional moment of inertia by photon absorptiometry. J Biomech 17:195–201
Horsman A, Currey JD (1983) Estimation of mechanical properties of the distal radius from bone mineral content and cortical width. Clin Orthop 176:298–304
Jurist JM, Foltz AS (1977) Human ulnar bending stiffness, mineral content, geometry and strength. J Biomech 10:455–459
Cameron JR, Sorenson JA (1963) Measurement of bone mineral in vivo: an improved method. Science 142:230–232
Weinstein RS, New KD, Sappington LJ (1991) Dual-energy x-ray absorptiometry versus single photon absorptiometry of the radius. Calcif Tissue Int 49:313–316
Larcos G, Wahner HW (1991) An evaluation of forearm bone mineral measurement with dual-energy x-ray absorptiometry. J Nucl Med 32:2101–2106
Overton TR, Wheeler GD (1992) Bone mass measurements in the distal forearm using dual-energy x-ray absorptiometry and x-ray computed tomography: a longitudinal, in vivo comparative study. J Bone Miner Res 7:375–381
Carter DR, Bouxsein ML, Marcus R (1992) New approaches for interpreting projected bone densitometry data. J Bone Miner Res 7:137–144
Ho CP, Kim RW, Schaffler MB, Sartoris DJ (1990) Accuracy of dual-energy radiographic absorptiometry of the lumbar spine: cadaver study. Radiology 176:171–173
Overgaard K, Hansen MA, Riis BJ, Christiansen C (1992) Discriminatory ability of bone mass measurements (SPA and DEXA) for fractures in elderly post-menopausal women. Calcif Tissue Int 50:30–35
Hui SL, Slemenda CW, Johnston CC Jr (1989) Baseline measurement of bone mass predicts fracture in white women. Ann Int Med 111:355–361
Hui SL, Slemenda CW, Johnston CC (1988) Age and bone mass as predictors of fracture in a prospective study. J Clin Invest 81:1804–1809
Eastell R, Wahner HW, O'Fallen M, Amadio PC, Melton LJ III, Riggs BL (1989) Unequal decrease in bone density of lumbar spine and ultradistal radius in Colles' and vertebral fracture syndromes. J Clin Invest 83:168–174
Hesp R, Klenerman L, Page L (1984) Decreased radial bone mass in Colles' fracture. Acta Orthop Scand 55:573–575
Nilsson BE, Westlin NE (1974) The bone mineral content in the forearm of women with Colles' fracture. Acta Orthop Scand 45:836–844
Harma M, Karjalainen P (1986) Trabecular osteopenia in Colles' fracture. Acta Orthop Scand 57:38–40
Gardsell P, Johnell O, Nilsson BE (1989) Predicting fractures in women by using forearm bone densitometry. Calcif Tissue Int 44:235–242
Lester GE, Anderson JJB, Tylavsky FA, Sutton WR, Stinnett SS, DeMasi RA, Talmage RV (1990) Update on the use of distal radial bone density measurements in prediction of hip and Colles' fracture risk. J Orthop Res 8:220–226
Eastell R, Riggs BL, Wahner HW, O'Fallon WM, Amadio PC, Melton LJ (1989) Colles' fracture and bone density of the ultradistal radius. J Bone Miner Res 4:607–613
Smith DA, Hosie CJ, Deacon AD, Hamblen DL (1990) Quantitative x-ray computed tomography of the radius in normal subjects and osteoporotic patients. Br J Radiol 63:776–782
Smith DA, Johnston CC, Yu P-L (1972) In vivo measurement of bone mass. Its use in demineralized states such as osteoporosis. JAMA 219:325–329
Grubb SA, Jacobson PC, Awbrey BJ, McCartney WH, Vincent LM, Talmage RV (1984) Bone density in osteopenic women: a modified distal radius density measurement procedure to develop an “at risk” value for use in screening women. J Orthop Res 2:322–327
Ross PD, Davis JW, Epstein RS, Wasnich RD (1991) Preexisting fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med 114:919–923
Cummings SR, Black DM, Nevitt MC, Browner WS, Cauley JA, Genant HK, Mascioli SR, Scott JC (1990) Appendicular bone density and age predict hip fracture in women. JAMA 263:665–668
Voort J, Taconis WK, Schaik CL, Silberbusch J (1990) The relationship between densitometry of the radius and vertebral fractures. Neth J Med 37:53–57
Black DM, Cummings SR, Genant HK, Nevitt MC, Palermo L, Browner W (1992) Axial and appendicular bone density predict fractures in older women. J Bone Miner Res 7:633–638
Hayes WC, Gerhart TN (1985) Biomechanics of bone: applications for assessment of bone strength. In: Peck WA (ed) Bone and mineral research, annual III. Elsevier Science Publishers, Amsterdam, pp 259–294
Shames IH (1967) Engineering mechanics: statics and dynamics. Prentice-Hall, Englewood Cliffs
Ruff CB, Hayes WC (1984) Bone mineral content in the lower limb: relationship to cross-sectional geometry. J Bone Joint Surg [Am] 66:1024–1031
Schlenker RA, VonSeggen WW (1976) The distribution of cortical and trabecular bone mass along the lengths of the radius and ulna and the implications for in vivo bone mass measurements. Calcif Tissue Int 20:41–52
Nagurka ML, Hayes WC (1980) Technical note: an interactive graphics package for calculating cross-sectional properties of complex shapes. J Biomech 13:59–64
Dixon WJ (1990) BMDP statistical software manual. University of California Press, Berkeley
Frykman G (1967) Fracture of the distal radius including sequelae-shoulder-hand-finger syndrome: disturbance in the distal radio-ulmar joint and impairment of nerve function. A clinical and experimental study. Acta Orthop Scand 108:1–153
Spadaro JA, Werner FW, Brenner RA, Fay LA, Fortino MD (1992) The contribution of cortical bone to osteopenic distal radius strength. Trans 38th ORS 17:113
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Myers, E.R., Hecker, A.T., Rooks, D.S. et al. Geometric variables from DXA of the radius predict forearm fracture load in vitro . Calcif Tissue Int 52, 199–204 (1993). https://doi.org/10.1007/BF00298718
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DOI: https://doi.org/10.1007/BF00298718