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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/17193

Title: Early Changes in Bone Density, Microarchitecture, Bone Resorption, and Inflammation Predict the Clinical Outcome 12 Weeks After Conservatively Treated Distal Radius Fractures: An Exploratory Study
Authors: Meyer, Ursina
de Jong, Joost J.
Bours, Sandrine G. P.
Keszei, Andras P.
Arts, Jacobus J.C.
Brink, Peter R. G.
Menheere, Paul
van Geel, Tineke A. C. M.
van Rietbergen, Bert
van den Bergh, Joop
Willems, Paul C.
Issue Date: 2014
Citation: JOURNAL OF BONE AND MINERAL RESEARCH, 29 (9), p. 2065-2073
Abstract: Fracture healing is an active process with early changes in bone and inflammation. We performed an exploratory study evaluating the association between early changes in densitometric, structural, biomechanical, and biochemical bone parameters during the first weeks of fracture healing and wrist-specific pain and disability at 12 weeks in postmenopausal women with a conservatively treated distal radius fracture. Eighteen patients (aged 64 +/- 8 years) were evaluated at 1 to 2 and 3 to 4 weeks postfracture, using high-resolution peripheral quantitative computed tomography (HR-pQCT), micro-finite element analysis, serum procollagen type-I N-terminal propeptide (P1NP), carboxy-terminal telopeptide of type I collagen (ICTP), and high-sensitive C-reactive protein (hsCRP). After 12 weeks, patients rated their pain and disability using Patient Rated Wrist Evaluation (PRWE) questionnaire. Additionally, Quick Disability of the Arm Shoulder and Hand (QuickDASH) questionnaire and active wrist range of motion was evaluated. Linear regression models were used to study the relationship between changes in bone parameters and in hsCRP from visit 1 to 2 and PRWE score after 12 weeks. A lower PRWE outcome, indicating better outcome, was significantly related to an early increase in trabecular bone mineral density (BMD) (beta -0.96 [95% CI -1.75 to - 0.16], R-2 = 0.37), in torsional stiffness (-0.14 [-0.28 to -0.004], R-2 = 0.31), and to an early decrease in trabecular separation (209 [15 to 402], R-2 = 0.33) and in ICTP (12.1 [0.0 to 24.1], R-2 = 0.34). Similar results were found for QuickDASH. Higher total dorsal and palmar flexion range of motion was significantly related to early increase in hsCRP (9.62 [3.90 to 15.34], R-2 = 0.52). This exploratory study indicates that the assessment of early changes in trabecular BMD, trabecular separation, calculated torsional stiffness, bone resorption marker ICTP, and hsCRP after a distal radius fracture provides valuable information regarding the 12-week clinical outcome in terms of pain, disability, and range of motion and validates its use in studies on the process of early fracture healing. (C) 2014 American Society for Bone and Mineral Research.
Notes: [Meyer, Ursina] Maastricht Univ, Dept Human Movement Sci, NL-6229 ER Maastricht, Netherlands. [Meyer, Ursina; de Jong, Joost J.; van Geel, Tineke A. C. M.; van den Bergh, Joop P. W.] Maastricht Univ, Res Sch NUTRIM, NL-6229 ER Maastricht, Netherlands. [Meyer, Ursina] Univ Zurich, Ctr Aging & Mobil, Zurich, Switzerland. [de Jong, Joost J.; Bours, Sandrine G. P.] Maastricht Univ, Med Ctr, Dept Internal Med, NL-6229 ER Maastricht, Netherlands. [Keszei, Andras P.] Rhein Westfal TH Aachen, Dept Med Informat, Aachen, Germany. [Arts, Jacobus J.; Willems, Paul C.] Maastricht Univ, Med Ctr, Dept Orthopaed Surg, NL-6229 ER Maastricht, Netherlands. [Arts, Jacobus J.; van Geel, Tineke A. C. M.; Geusens, Piet P.; Willems, Paul C.] Maastricht Univ, Res Sch CAPHRI, NL-6229 ER Maastricht, Netherlands. [van Rietbergen, Bert] Eindhoven Univ Technol, Dept Biomed Engn, NL-5600 MB Eindhoven, Netherlands. [Brink, Peter R. G.] Maastricht Univ, Med Ctr, Dept Trauma Surg, NL-6229 ER Maastricht, Netherlands. [Menheere, Paul] Maastricht Univ, Med Ctr, Cent Diagnost Lab, NL-6229 ER Maastricht, Netherlands. [Arts, Jacobus J.; van Geel, Tineke A. C. M.] Maastricht Univ, Dept Family Med, NL-6229 ER Maastricht, Netherlands. [van den Bergh, Joop P. W.; Geusens, Piet P.] Hasselt Univ, Biomed Res Ctr, Hasselt, Belgium. [van den Bergh, Joop P. W.] Viecuri Med Ctr Venlo, Dept Internal Med, Venlo, Netherlands. [Geusens, Piet P.] Maastricht Univ, Med Ctr, Dept Rheumatol, NL-6229 ER Maastricht, Netherlands.
URI: http://hdl.handle.net/1942/17193
DOI: 10.1002/jbmr.2225
ISI #: 000340846000017
ISSN: 0884-0431
Category: A1
Type: Journal Contribution
Validation: ecoom, 2015
Appears in Collections: Research publications

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