ArticleBone & joint research2017
Ultimate fracture load of cadaver proximal humeri correlates more strongly with mean combined cortical thickness than with areal cortical index, DEXA density, or canal-to-calcar ratio.
Article in Bone & joint research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Immediate intensive mobilization compared with immediate conventional mobilization for the impacted osteoporotic conservatively treated proximal humeral fracture: a randomized controlled trial.Musculoskeletal surgery · 2017Trial
- The medial cortical ratio as a risk factor for failure after surgical fixation of proximal humerus fractures in elderly patients.Joint diseases and related surgery · 2023Article
- Cortical bone thickness of the distal radius predicts the local bone mineral density.Bone & joint research · 2021Article
- Preoperative measures of bone mineral density from digital wrist radiographs.Bone & joint research · 2021Article
- Cortical bone thickness predicts the quantitative bone mineral density of the proximal humerus.Archives of osteoporosis · 2021Article
- The biomechanics of proximal humeral fractures: Injury mechanism and cortical morphology.Shoulder & elbow · 2019Article
- Radiographic predictors for bone mineral loss: Cortical thickness and index of the distal femur.Bone & joint research · 2018Article
- The Circle-Fit Method Helps Make Reliable Cortical Thickness Measurements Regardless of Humeral Length.Geriatric orthopaedic surgery & rehabilitation · 2018Article
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3 authors.
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Abstract
objectivesThis investigation sought to advance the work published in our prior biomechanical study (Journal of Orthopaedic Research, 2016). We specifically sought to determine whether there are additional easy-to-measure parameters on plain radiographs of the proximal humerus that correlate more strongly with ultimate fracture load, and whether a parameter resembling the Dorr strength/quality characterisation of proximal femurs can be applied to humeri. MATERIALS AND
methodsA total of 33 adult humeri were used from a previous study where we quantified bone mineral density of the proximal humerus using radiographs and dual-energy x-ray absorptiometry (DEXA), and regional mean cortical thickness and cortical index using radiographs. The bones were fractured in a simulated backwards fall with the humeral head loaded at 2 mm/second via a frustum angled at 30° from the long axis of the bone. Correlations were assessed with ultimate fracture load and these new parameters: cortical index expressed in areas ("areal cortical index") of larger regions of the diaphysis; the canal-to-calcar ratio used analogous to its application in proximal femurs; and the recently described medial cortical ratio.
resultsThe three new parameters showed the following correlations with ultimate fracture load: areal cortical index (r = 0.56, p < 0.001); canal-to-calcar ratio (r = 0.38, p = 0.03); and medial cortical ratio (r = 0.49, p < 0.005). These correlations were weaker when compared with those that we previously reported: mean cortical thickness of the proximal diaphysis versus ultimate fracture load (r = 0.71; p < 0.001); and mean density in the central humeral head versus ultimate fracture load (r = 0.70; p < 0.001).
conclusionSimple-to-measure radiographic parameters of the proximal humerus reported previously are more useful in predicting ultimate fracture load than are areal cortical index, canal-to-calcar ratio, and medial cortical ratio.Cite this article: J. G. Skedros, C. S. Mears, W. Z. Burkhead. Ultimate fracture load of cadaver proximal humeri correlates more strongly with mean combined cortical thickness than with areal cortical index, DEXA density, or canal-to-calcar ratio. Bone Joint Res 2017;6:1-7. DOI: 10.1302/2046-3758.61.BJR-2016-0145.R1.
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