Association of Bone Quality Measured by Noncontrast Computed Tomography Scan and Three-dimensional Computed Tomography-based Fracture Pattern in Intertrochanteric Femur Fracture in Adults.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL

Annals of African Medicine Pub Date : 2025-10-09 DOI:10.4103/aam.aam_284_25

Govind Kumar Gupta, Saumya Kullu, Abhishek Guria, Kumar Gourab, Sudha Rani

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Abstract

Background: Understanding intertrochanteric (IT) femur fractures, their causes, classifications, and the role of bone quality is crucial for management. Poor bone quality associated with osteoporosis increases fracture risk and poorer outcomes. While dual-energy X-ray absorptiometry is the gold standard, Hounsfield units (HUs) derived from computed tomography (CT) scans are a valuable, noninvasive alternative for assessing bone quality.

Aim and objectives: To determine the association of bone quality, measured by noncontrast CT scan, with three-dimensional CT (3D-CT)-based fracture patterns in IT femur fractures in adults.

Materials and methods: Over a period of 18 months, 137 patients with IT femoral fractures were included. Fracture classification using Evans (1949), Boyd and Griffin (1956), and Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) (2018) was done. Bone quality was assessed by calculating the HU value from the largest spherical region of interest in the IT region of the unaffected side. 3D-CT-based classification system by Dr. R. B. Kalia and Dr. Shobha S. Arora was used.

Results: The mean age was 65.4 ± 10.2 years, with females comprising 59.9%. AO/OTA type 31A2.2 was the most common, indicating frequent unstable fractures. Patients with stable fractures had significantly higher mean HU values (130.2 ± 22.1) compared to those with unstable fractures (105.4 ± 24.3) (P < 0.001). A significant correlation (P < 0.001) between the AO/OTA (2018) classification and the CT-based classification is evident.

Conclusion: Lower HU values, indicating poorer bone quality, are strongly associated with unstable fracture patterns. The significant correlation between CT-based assessments and AO/OTA classification validates the utility of advanced imaging techniques in assessing bone strength and fracture risk.

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成人股骨粗隆间骨折非对比ct扫描与三维ct骨折模式测量骨质量的相关性研究。

背景：了解股骨粗隆间骨折及其原因、分类和骨质量的作用对治疗至关重要。骨质疏松症相关的骨质质量差会增加骨折风险和较差的预后。虽然双能x线吸收仪是金标准，但源自计算机断层扫描（CT）的霍斯菲尔德单位（HUs）是评估骨质量的一种有价值的、无创的替代方法。目的和目的：确定成人IT股骨骨折的骨质量（通过非对比CT扫描测量）与三维CT （3D-CT）骨折模式的关系。材料和方法：在18个月的时间里，纳入137例IT股骨折患者。采用Evans（1949）、Boyd和Griffin（1956）和Arbeitsgemeinschaft f r osteosynthesis efragen/Orthopaedic Trauma Association (AO/OTA)（2018）对骨折进行分类。通过计算未受影响侧IT区域感兴趣的最大球形区域的HU值来评估骨质量。采用Dr. R. B. Kalia和Dr. Shobha S. Arora基于3d - ct的分类系统。结果：平均年龄65.4±10.2岁，女性占59.9%。AO/OTA型31A2.2最为常见，表明不稳定骨折多发。稳定型骨折患者的平均HU值（130.2±22.1）明显高于不稳定型骨折患者（105.4±24.3）（P < 0.001）。AO/OTA（2018）分类与基于ct的分类之间存在显著相关性（P < 0.001）。结论：较低的HU值表明较差的骨质量与不稳定骨折模式密切相关。基于ct的评估与AO/OTA分类之间的显著相关性验证了先进成像技术在评估骨强度和骨折风险方面的实用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of African Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

0.90

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0.00%

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期刊介绍： The Annals of African Medicine is published by the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria and the Annals of African Medicine Society. The Journal is intended to serve as a medium for the publication of research findings in the broad field of Medicine in Africa and other developing countries, and elsewhere which have relevance to Africa. It will serve as a source of information on the state of the art of Medicine in Africa, for continuing education for doctors in Africa and other developing countries, and also for the publication of meetings and conferences. The journal will publish articles I any field of Medicine and other fields which have relevance or implications for Medicine.