ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024
Comparison of the zonal distribution of calcium salt density and fat marrow in bone-healthy and osteoporotic sacra: an image data analysis using quantitative computed tomography and magnetic resonance imaging.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.
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3 citing papers in PubMed, 2 citations in OpenAlex.
- A retrospective comparative study of traditional PVP and bone cement pedicle-anchored PVP techniques for stage I and II Kümmell's disease.BMC musculoskeletal disorders · 2026Article
- Diagnostic Value of Opportunistic CT-Based Bone Density Assessment in Patients with and Without Sacral Insufficiency Fractures.Diagnostics (Basel, Switzerland) · 2025Article
- Correlation analysis between the mDIXON-quant fat quantification parameters of the infrapatellar fat pad and the severity of knee osteoarthritis.Journal of orthopaedic surgery and research · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePathogenesis of sacral fragility fractures is not fully understood. This study investigates zonal distribution of calcium salt and fat marrow in intact bone-healthy and osteoporotic pelvis. In addition, in unilateral sacral fractures, the fracture side was compared with the intact side.
methodsCT and MRI images of 37 pelves were analyzed. Zonal calcium salt distribution by Hounsfield units (HU) was recorded for each CT dataset. Fat marrow content was measured in MRI mDixon-Quant sequence. The cohort was divided: intact pelves with (PEO, HU < 100, n = 8) and without osteoporosis (PE, HU ≥ 100, n = 14) based on the mean HU value in LWK5. A third group consisted of patients with osteoporosis and unilateral fractures (PEOFx, n = 10).
conclusionThe results suggest that in PEO sacral alae experience disproportionate skeletal rarefaction. This concerns the sacral ala at the S1 level (- 25 ± 55), whereby the calcium salt content is so low that it corresponds to the S3 level of healthy bone (- 20 ± 21 HU). This explains the occurrence of transalar fractures in the load-transmitting zone S1. In PEOFx, the calcium salt density was higher and the fat content was lower on the fractured side than on the intact side, indicating bony compacting due to lateral compression and fat displacement due to hematoma in the accident mechanism. This study makes an important contribution to the understanding of the development of sacral fragility fractures. Furthermore, impaction of the cancellous bone within the fracture can be demonstrated.
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