Three-dimensional distribution of bone density in the proximal humerus
- 1 December 2003
- journal article
- research article
- Published by Springer Science and Business Media LLC in Calcified Tissue International
- Vol. 73 (6), 531-536
- https://doi.org/10.1007/s00223-002-0013-9
Abstract
Bone quality of the proximal humerus is important for the surgical treatment of proximal humeral fractures and rotator cull tears. However, very few studies have evaluated the areal bone mineral density (BMD) of the proximal humerus. The aim of this study was to analyze the volumetric BMD (vBMD) using peripheral-quantitative-computed-tomography. Total, trabecular and cortical vBMD were determined separately for the proximal and distal half of the humeral head, the surgical neck and seven specific regions of interest. The greater tuberosity (GT) was divided into three regions, and the lesser tuberosity (LT) and articular surface (AS) were each divided into two regions. The proximal head showed a significantly higher trabecular (+46%) and cortical vBMD (+15%) than the distal one. The mean trabecular vBMD of AS was significantly higher (+80%), and the cortical vBMD was significantly lower (-11%) than that of the tuberosities. In the proximal half of GT, trabecular vBMD was higher in the posterior than in the middle and anterior regions. Cortical vBMD was higher in middle region than in the anterior and posterior ones. In the distal half of GT, trabecular vBMD was significantly higher in the posterior than in the middle region, and cortical vBMD was significantly higher in the anterior than in the middle region. In the proximal half of AS, trabecular vBMD was significantly higher in the posterior region than in the anterior one. These results point to bone sites that may provide stronger fixation for implants, reduce the risk of implant loosening, and therefore improve patient outcome.Keywords
This publication has 23 references indexed in Scilit:
- Epidemiology and outcomes of osteoporotic fracturesThe Lancet, 2002
- The Prevalence of OsteoporosisJournal of Bone and Mineral Research, 1997
- A Biomechanical Evaluation Of Suture Anchors In Repair Of The Rotator CuffThe Journal of Bone and Joint Surgery. British volume, 1997
- Surgical Neck Fractures of the Proximal HumerusThe Journal of Trauma and Acute Care Surgery, 1996
- Effects of selected thermal variables on the mechanical properties of trabecular boneBiomaterials, 1995
- Distribution of bone mineral density and bone strength of the proximal humerusJournal of Shoulder and Elbow Surgery, 1994
- Pull-out strength of suture anchors for rotator cuff and Bankart lesion repairsThe American Journal of Sports Medicine, 1993
- The effect of different storage methods on the mechanical properties of trabecular boneJournal of Biomechanics, 1993
- Statistical guidelines for contributors to medical journals.BMJ, 1983
- Epidemiologic Features of Humeral FracturesClinical Orthopaedics and Related Research, 1982