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Title: Effect of a Cast on Short-Term Reproducibility and Bone Parameters Obtained from HR-pQCT Measurements at the Distal End of the Radius
Authors: de Jong, Joost J. A.
Arts, Jacobus J.C.
Meyer, Ursina
Willems, Paul C.
Geusens, Piet P.
van den Bergh, Joop P. W.
van Rietbergen, Bert
Issue Date: 2016
Abstract: Background: High-resolution peripheral quantitative computed tomography (HR-pQCT) is a promising tool to assess the fracture-healing process at the microscale in vivo. Since casts are often used during fracture treatment, they might affect the assessment of bone density, microarchitectural, and biomechanical parameters and the short-term reproducibility of those parameters, e.g., as a result of beam-hardening. The aim of this study was to assess the effect of a plaster-of-Paris and/or fiberglass cast on bone parameters and on the short-term reproducibility of the HR-pQCT measurements of those parameters. Methods: The effects of a cast on HR-pQCT-derived bone parameters were evaluated by comparing HR-pQCT scans of fifteen human cadaveric distal radial specimens from one male and fourteen female donors (median age, eighty-four years [ range, sixty-two to ninety years] at the time of death) in three conditions: with a plaster-of-Paris cast, with a fiberglass cast, or without a cast. Short-term reproducibility was assessed using duplicate scans of the distal end of the radius in sixteen healthy volunteers without a fracture (nine men and seven women with a median age of twenty-six years; range, twenty-two to thirty-nine years) while wearing and not wearing a fiberglass cast. Results: Compared with measurements made with no cast, the plaster-of-Paris cast introduced a systematic error in the bone parameters ranging from -2.6% in trabecular separation to -9.8% in cortical thickness. Bone parameters were affected only marginally by fiberglass, with errors between -0.6% and -1.6% in trabecular separation and cortical thickness, respectively. Short-term reproducibility with a fiberglass cast was similar to that with no cast: approximately 1% for bone density parameters, 4% to 5% for microarchitectural parameters, and 3% to 4% for biomechanical parameters. Conclusions: A plaster-of-Paris cast has a considerable effect on HR-pQCT measurements. A fiberglass cast only marginally affects the bone parameters, and the short-term reproducibility of HR-pQCT measurements in patients with a fiberglass cast is comparable with that in patients without a cast. In studies on fracture-healing using HR-pQCT, a fiberglass cast is desirable if immobilization is indicated. The use of a plaster-of-Paris cast should be avoided if possible; however, if not avoidable, corrections after the scan are desirable to adjust for the error introduced in the bone parameters.
Notes: [de Jong, Joost J. A.; Arts, Jacobus J.; Meyer, Ursina; Willems, Paul C.; Geusens, Piet P.; van den Bergh, Joop P. W.; van Rietbergen, Bert] Eindhoven Univ Technol, Fac Biomed Engn, POB 513, NL-5600 MB Eindhoven, Netherlands. [de Jong, Joost J. A.; Meyer, Ursina; van den Bergh, Joop P. W.] Maastricht Univ, Res Sch NUTRIM, NL-6200 MD Maastricht, Netherlands. [Arts, Jacobus J.; Willems, Paul C.; Geusens, Piet P.] Maastricht Univ, CAPHRI, NL-6200 MD Maastricht, Netherlands. [de Jong, Joost J. A.; Meyer, Ursina; Geusens, Piet P.; van den Bergh, Joop P. W.] Maastricht Univ, Med Ctr, Dept Rheumatol, NL-6200 MD Maastricht, Netherlands. [Arts, Jacobus J.; Willems, Paul C.] Maastricht Univ, Med Ctr, Dept Orthopaed Surg, NL-6200 MD Maastricht, Netherlands. [Meyer, Ursina] Maastricht Univ, Med Ctr, Dept Human Movement Sci, NL-6200 MD Maastricht, Netherlands. [van den Bergh, Joop P. W.] Hasselt Univ, Fac Med & Life Sci, Hasselt, Belgium. [van den Bergh, Joop P. W.] VieCuri Med Ctr, Dept Internal Med, Venlo, Netherlands.
URI: http://hdl.handle.net/1942/21811
DOI: 10.2106/JBJS.O.00127
ISI #: 000371147700007
ISSN: 0021-9355
Category: A1
Type: Journal Contribution
Validation: ecoom, 2017
Appears in Collections: Research publications

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