Assessment of the healing of conservatively-treated scaphoid fractures using HR-pQCT

• DOI: 10.1016/j.bone.2021.116161
• Publication Date: 2021-08-27T09:54:47Z
• Authors: M.S.A.M. Bevers; A.M. Daniels; B. van Rietbergen; P.P.M.M. Geusens; S.M.J. van Kuijk; S. Sassen; S. Kaarsemaker; P.F.W. Hannemann; M. Poeze; H.M.J. Janzing; J.P. van den Bergh; C.E. Wyers
• Keywords: Scaphoid fracture

Improving the clinical outcome of scaphoid fractures may benefit from adequate monitoring their healing in order to for example identify complications such as nonunion at an early stage and adjust treatment strategy accordingly. However, quantitative assessment process is limited with current imaging modalities. In this study, high-resolution peripheral computed tomography (HR-pQCT) was used first time assess changes bone density, microarchitecture, strength during conservatively-treated fractures. Thirteen patients a fracture (all confirmed on HR-pQCT eleven CT) received scan baseline three, six, twelve, 26 weeks after presentation emergency department. Bone mineral density (BMD) trabecular microarchitecture were quantified, failure load (FL) estimated using micro-finite element analysis. Longitudinal evaluated linear mixed-effects models. Data two excluded due surgical intervention twelve-week follow-up visit. fully evaluable patients, line became more apparent 3 weeks. At 6 weeks, individual trabeculae region difficult distinguish neighboring trabeculae, phenomenon concerned larger around 12 Quantitative showed that BMD FL significantly lower than all visits largest change (-13.6% - 23.7%, respectively). remained unchanged thereafter, while increased. Trabecular thickness decreased three (-3.9%), six (-6.7%), twelve (-4.4%) number (-4.5%), (-7.3%), (-7.9%) separation higher (+13.3%), (+19.7%), (+16.3%) To conclude, explorative study substantial decrease BMD, Tb.Th, fractures, followed by stabilization or increase these parameters. not returned values.