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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/21707

Title: Fracture Repair in the Distal Radius in Postmenopausal Women: A Follow-Up 2 Years Postfracture Using HRpQCT
Authors: de Jong, Joost J. A.
Heyer, Frans L.
Arts, Jacobus J.C.
Poeze, Martijn
Keszei, Andras P.
Willems, Paul C.
van Rietbergen, Bert
Geusens, Piet P.
Van den Bergh, Joop
Issue Date: 2016
Citation: JOURNAL OF BONE AND MINERAL RESEARCH, 31 (5), p. 1114-1122
Abstract: Fracture healing is characterized by an intense increase in modeling and remodeling of bone, which allows removal of the cast after a stable distal radius fracture within 3 to 5 weeks. However, at that time, bone strength has not recovered yet. We studied the changes in bone mineral density (BMD), microarchitecture, and bone stiffness after a distal radius fracture during a 2-year follow-up in comparison to the contralateral side and the association between the 2-year stiffness and baseline BMD, microarchitecture, and early changes in these parameters. The fractured side of 14 postmenopausal women (mean age 64 8 years) with a conservatively treated distal radius fracture was scanned by high-resolution peripheral quantitative computed tomography (HRpQCT) at 1 to 2,3 to 4,6 to 8, and 12 weeks and 2 years postfracture. The same region contralaterally was scanned as well at the 2-year visit. BMD, microarchitecture, and stiffness parameters were determined and the fracture side was compared with the contralateral side using a linear mixed-effect model. Spearman's correlation was used to correlate the 2-year bone stiffness with baseline BMD, microarchitecture, and early 3-month changes in these parameters. Two years postfracture, cortical and trabecular thickness and torsional and bending stiffness were significantly higher at the fractured side compared with the nonfractured side (21%, 55%, 31%, and 29%, respectively, p < 0.05), whereas BMD was similar. Two-year torsional and bending stiffness correlated significantly with baseline BMD and cortical perimeter (vertical bar rho vertical bar >= 0.63, p < 0.016) but not with early changes in bone parameters. Using HRpQCT, this study illustrates that fracture healing is not completed by the time the cast is removed. We showed that from 6 weeks to 2 years postfracture, large changes occur in BMD, microarchitecture, and biomechanical parameters at the fractured side, which were fully recovered after 2 years in comparison to the nonfractured contralateral side. Interestingly, higher 2-year torsional and bending stiffness were associated with lower BMD and higher cortical perimeter at baseline. (C) 2015 American Society for Bone and Mineral Research.
Notes: [de Jong, Joost J. A.; Heyer, Frans L.; Poeze, Martijn; van den Bergh, Joop P. W.] Maastricht Univ, Med Ctr, NUTRIM Sch Nutr & Translat Res Metab, NL-6200 MD Maastricht, Netherlands. [de Jong, Joost J. A.; Geusens, Piet P.; van den Bergh, Joop P. W.] Maastricht Univ, Med Ctr, Dept Rheumatol, POB 5800, NL-6202 AZ Maastricht, Netherlands. [Heyer, Frans L.; Poeze, Martijn] Maastricht Univ, Med Ctr, Dept Surg, NL-6200 MD Maastricht, Netherlands. [Heyer, Frans L.; van den Bergh, Joop P. W.] VieCuri Med Ctr, Dept Internal Med, Venlo, Netherlands. [Arts, Jacobus J. C.; Willems, Paul C.] Maastricht Univ, Med Ctr, Dept Orthoped Surg, NL-6200 MD Maastricht, Netherlands. [Arts, Jacobus J. C.; Willems, Paul C.; Geusens, Piet P.] Maastricht Univ, Med Ctr, CAPHRI Sch Publ Hlth & Primary Care, NL-6200 MD Maastricht, Netherlands. [Keszei, Andras P.] Uniklin RWTH Aachen Univ, Dept Med Informat, Aachen, Germany. [van Rietbergen, Bert] Eindhoven Univ Technol, Fac Biomed Engn, POB 513, NL-5600 MB Eindhoven, Netherlands. [Geusens, Piet P.; van den Bergh, Joop P. W.] Hasselt Univ, Fac Med & Life Sci, Hasselt, Belgium.
URI: http://hdl.handle.net/1942/21707
DOI: 10.1002/jbmr.2766
ISI #: 000377270400022
ISSN: 0884-0431
Category: A1
Type: Journal Contribution
Validation: ecoom, 2017
Appears in Collections: Research publications

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