Assessment of the bone mineral density and microstructure of the human femoral head according to different tip-apex distances can guide the treatment of intertrochanteric hip fractures
Background/Aim: We analyzed the microstructure and bone mineral density of the trabecular bone in the femoral head of patients with osteoporosis.
Patients and Methods: Sixteen femoral heads with osteoporotic femoral neck fractures underwent micro-computed tomography scanning. In each tip-apex distance (TAD) of 15, 20, and 25 mm, five regions of interest (ROIs) were extracted from the central, anterior, posterior, superior, and inferior sections. A total of 15 ROIs were extracted from TADs of 15, 20, and 25 mm. The measurement parameters included bone mineral density (BMD), percent bone volume: bone volume/total volume (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), structural model index (SMI), and degree of anisotropy (DOA).
Results: The lowest BMD and BV/TV values were observed in the inferior region and differed significantly from those in other regions (P<0.05). Lower Tb.Th and Tb.N values were observed in the inferior region compared with those in the central region (P<0.05). The highest SMI value was observed in the inferior region (P<0.05). With TAD of 15 and 20 mm, the DOA values in the inferior region were lower than those in the anterior region (P<0.05). Lower BMD and BV/TV values were observed in the anterior, central, and inferior regions of TAD of 15 mm compared with those in the corresponding regions of TAD of 25 mm (P<0.05).
Conclusion: Positioning the lag screw between TAD of 20-25 mm and in the inferior region is recommended, and TAD of less than 15 mm is not recommended.
Conclusion: Positioning the lag screw between TAD of 20-25 mm and in the inferior region is recommended, and TAD of less than 15 mm is not recommended.
Key Words: Osteoporosis; Femoral head; Microarchitecture; Micro computed tomography; Bone mineral density
