PMID- 26758746
OWN - NLM
STAT- MEDLINE
DCOM- 20161006
LR  - 20181202
IS  - 1471-2474 (Electronic)
IS  - 1471-2474 (Linking)
VI  - 17
DP  - 2016 Jan 12
TI  - Analysis of trabecular bone microstructure in osteoporotic femoral heads in human 
      patients: in vivo study using multidetector row computed tomography.
PG  - 13
LID - 10.1186/s12891-015-0848-z [doi]
LID - 13
AB  - BACKGROUND: Lag screw position is very important in the treatment of 
      intertrochanteric femoral fracture to prevent complications such as screw 
      cut-out. Current studies recommend central or inferior placement of the lag screw 
      on the anteroposterior radiograph, and central placement on the lateral 
      radiographs. These reports are based on radiographic evaluation, but few studies 
      have investigated the importance of bone quality at the site of lag screw 
      placement. In this study, we used multidetector row computed tomography (MDCT) to 
      perform in vivo evaluation of the bone microstructure of the femoral head in 
      patients with intertrochanteric femoral fractures. METHODS: This study was 
      approved by the Ethics Committee of Okanami General Hospital. MDCT images were 
      obtained in our hospital from ten patients who had sustained intertrochanteric 
      femoral fracture. Patients who needed computed tomography to confirm fracture 
      morphology were included. We defined six areas as regions of interest (ROI): ROI 
      1-3 were defined as the femoral head apex area, and ROI 4-6 were defined as the 
      femoral neck area. Trabecular microstructure parameters, including mean bone 
      volume to total volume (BV/TV), trabecular thickness (Tb.Th), trabecular 
      separation (Tb.Sp), and structure model index (SMI), were evaluated with bone 
      analysis software (TRI/3D-BON). Statistical analyses were performed using EZR 
      software; each parameter among the ROIs was statistically evaluated by analysis 
      of variance (ANOVA) and Tukey's test. Statistical significance was established at 
      p < 0.05. RESULTS: In the apical area, all parameters indicated that ROI 1 
      (superior) had the highest bone quality and ROI 2 (central) was higher in bone 
      quality than ROI 3 (inferior). In the femoral neck, all parameters indicated that 
      bone quality was significantly greater in ROI 6 (inferior) than ROI 5 (central). 
      DISCUSSION AND CONCLUSIONS: We could evaluate bone quality with clinical MDCT in 
      vivo. Bone quality in the central area of the femoral head apical was greater 
      than in the inferior area, and bone quality in the inferior area of the femoral 
      neck was greater than in the central area. Recognizing which area of femoral head 
      has greater bone quality may lead to a better clinical result in treating 
      intertrochanteric femoral fracture.
FAU - Munemoto, Mitsuru
AU  - Munemoto M
AD  - Department of Orthopaedic Surgery, Nara Medical University, 840 Shijocho, 
      Kashihara, Nara, 634-8521, Japan. munemune@qj8.so-net.ne.jp.
AD  - Department of Orthopaedic Surgery, Okanami General Hospital, 1784 Uenokuuwamachi, 
      Iga, Mie, 518-0842, Japan. munemune@qj8.so-net.ne.jp.
FAU - Kido, Akira
AU  - Kido A
AD  - Department of Orthopaedic Surgery, Nara Medical University, 840 Shijocho, 
      Kashihara, Nara, 634-8521, Japan. akirakid@naramed-u.ac.jp.
FAU - Sakamoto, Yoshihiro
AU  - Sakamoto Y
AD  - Department of Orthopaedic Surgery, Nara Medical University, 840 Shijocho, 
      Kashihara, Nara, 634-8521, Japan. sakayosi@naramed-u.ac.jp.
FAU - Inoue, Kazuya
AU  - Inoue K
AD  - Department of Orthopaedic Surgery, Nara Medical University, 840 Shijocho, 
      Kashihara, Nara, 634-8521, Japan. kaz_inoue12@yahoo.co.jp.
FAU - Yokoi, Kazuyuki
AU  - Yokoi K
AD  - Department of Orthopaedic Surgery, Okanami General Hospital, 1784 Uenokuuwamachi, 
      Iga, Mie, 518-0842, Japan. k-yokoi@ma.mctv.ne.jp.
FAU - Shinohara, Yasushi
AU  - Shinohara Y
AD  - Department of Orthopaedic Surgery, Okanami General Hospital, 1784 Uenokuuwamachi, 
      Iga, Mie, 518-0842, Japan. y-shino@dk9.so-net.ne.jp.
FAU - Tanaka, Yasuhito
AU  - Tanaka Y
AD  - Department of Orthopaedic Surgery, Nara Medical University, 840 Shijocho, 
      Kashihara, Nara, 634-8521, Japan. yatanaka@naramed-u.ac.jp.
LA  - eng
PT  - Journal Article
DEP - 20160112
PL  - England
TA  - BMC Musculoskelet Disord
JT  - BMC musculoskeletal disorders
JID - 100968565
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Bone Density/*physiology
MH  - Clinical Decision-Making/methods
MH  - Female
MH  - Femur Head/*diagnostic imaging/*physiology/surgery
MH  - Humans
MH  - Male
MH  - Multidetector Computed Tomography/*methods/statistics & numerical data
MH  - Osteoporosis/*diagnostic imaging/surgery
PMC - PMC4710991
EDAT- 2016/01/14 06:00
MHDA- 2016/10/08 06:00
PMCR- 2016/01/12
CRDT- 2016/01/14 06:00
PHST- 2015/06/27 00:00 [received]
PHST- 2015/12/07 00:00 [accepted]
PHST- 2016/01/14 06:00 [entrez]
PHST- 2016/01/14 06:00 [pubmed]
PHST- 2016/10/08 06:00 [medline]
PHST- 2016/01/12 00:00 [pmc-release]
AID - 10.1186/s12891-015-0848-z [pii]
AID - 848 [pii]
AID - 10.1186/s12891-015-0848-z [doi]
PST - epublish
SO  - BMC Musculoskelet Disord. 2016 Jan 12;17:13. doi: 10.1186/s12891-015-0848-z.