Association of Bone Quality Measured by Noncontrast Computed Tomography Scan and Three-dimensional Computed Tomography-based Fracture Pattern in Intertrochanteric Femur Fracture in Adults
Year: 2025
Type: article
Study design: Observational Study
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.
Source: Annals of African Medicine
Authors: Govind Kumar Gupta, Saumya Kullu, Abhishek Guria, Kumar Gourab, Sudha Rani
Institution: Rajendra Institute of Medical Sciences
Language: English
Topic: Hip and Femur Fractures
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4414987119