CT-Based Evaluation of Bone Mineral Density Distribution of Proximal Femur in Patients With Femoral Trochanteric Fracture
Background Surgical treatment of proximal femoral fractures typically involves fixation with intramedullary nailing or sliding hip screws, where screws inserted into the femoral head stabilize the fracture site. However, few studies have quantitatively assessed the distribution of bone density and q...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-07-01
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| Series: | Geriatric Orthopaedic Surgery & Rehabilitation |
| Online Access: | https://doi.org/10.1177/21514593251361803 |
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| author | Daisuke Enomoto MD Hyonmin Choe MD, PhD Masahiro Matsumoto MD Koki Abe MD, PhD Kazuyoshi Yamamoto MD, PhD Kousuke Matsuo MD, PhD Hiroyuki Makita MD, PhD Naomi Kobayashi MD, PhD Yutaka Inaba MD, PhD |
| author_facet | Daisuke Enomoto MD Hyonmin Choe MD, PhD Masahiro Matsumoto MD Koki Abe MD, PhD Kazuyoshi Yamamoto MD, PhD Kousuke Matsuo MD, PhD Hiroyuki Makita MD, PhD Naomi Kobayashi MD, PhD Yutaka Inaba MD, PhD |
| author_sort | Daisuke Enomoto MD |
| collection | DOAJ |
| description | Background Surgical treatment of proximal femoral fractures typically involves fixation with intramedullary nailing or sliding hip screws, where screws inserted into the femoral head stabilize the fracture site. However, few studies have quantitatively assessed the distribution of bone density and quality within the femoral head. We investigated the distribution of bone mineral density (BMD) within the proximal femoral head, evaluated inter-patient variability, and examined associated factors based on computed tomography (CT) values. Methods This multicenter prospective observational study included 100 patients with femoral trochanteric fractures. Preoperative CT images were obtained from the first lumbar vertebra to the distal end of the femur. Using 3D Slicer (version 7), the proximal uninjured femur was segmented and reconstructed into a 3D model. The volume and CT values (Hounsfield units [HU]) of the proximal femur and femoral head were measured. Additionally, CT values were used to assess the bone volume and distribution of low bone-density areas (0-100 HU) and high bone-density areas (≥300 HU) in the femoral head. Results The average bone volume and CT values of proximal femur and femoral head were 90,641 mm 3 and 94 HU, and 32,316 mm 3 and 131 HU, respectively. The volume of the femoral head with CT values ≥300 HU was 2967 mm 3 , accounting for 9.1% of the total volume (range: 0.1%-32.6%), with a distribution observed along the central region of the femoral head, particularly along the principal compressive trabeculae. Additionally, the average CT value of the femoral head (<100 HU, ≥300 HU) correlated with bone volume. Conclusion A distribution of CT values within the femoral head is characteristic of patients with femoral trochanteric fractures. Using HU values from CT imaging to predict bone fragility preoperatively may aid in assessing the risk of postoperative complications. |
| format | Article |
| id | doaj-art-4c29d31d1abe4f7bbee1b583a3788a89 |
| institution | Kabale University |
| issn | 2151-4593 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Geriatric Orthopaedic Surgery & Rehabilitation |
| spelling | doaj-art-4c29d31d1abe4f7bbee1b583a3788a892025-08-20T03:51:29ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45932025-07-011610.1177/21514593251361803CT-Based Evaluation of Bone Mineral Density Distribution of Proximal Femur in Patients With Femoral Trochanteric FractureDaisuke Enomoto MDHyonmin Choe MD, PhDMasahiro Matsumoto MDKoki Abe MD, PhDKazuyoshi Yamamoto MD, PhDKousuke Matsuo MD, PhDHiroyuki Makita MD, PhDNaomi Kobayashi MD, PhDYutaka Inaba MD, PhDBackground Surgical treatment of proximal femoral fractures typically involves fixation with intramedullary nailing or sliding hip screws, where screws inserted into the femoral head stabilize the fracture site. However, few studies have quantitatively assessed the distribution of bone density and quality within the femoral head. We investigated the distribution of bone mineral density (BMD) within the proximal femoral head, evaluated inter-patient variability, and examined associated factors based on computed tomography (CT) values. Methods This multicenter prospective observational study included 100 patients with femoral trochanteric fractures. Preoperative CT images were obtained from the first lumbar vertebra to the distal end of the femur. Using 3D Slicer (version 7), the proximal uninjured femur was segmented and reconstructed into a 3D model. The volume and CT values (Hounsfield units [HU]) of the proximal femur and femoral head were measured. Additionally, CT values were used to assess the bone volume and distribution of low bone-density areas (0-100 HU) and high bone-density areas (≥300 HU) in the femoral head. Results The average bone volume and CT values of proximal femur and femoral head were 90,641 mm 3 and 94 HU, and 32,316 mm 3 and 131 HU, respectively. The volume of the femoral head with CT values ≥300 HU was 2967 mm 3 , accounting for 9.1% of the total volume (range: 0.1%-32.6%), with a distribution observed along the central region of the femoral head, particularly along the principal compressive trabeculae. Additionally, the average CT value of the femoral head (<100 HU, ≥300 HU) correlated with bone volume. Conclusion A distribution of CT values within the femoral head is characteristic of patients with femoral trochanteric fractures. Using HU values from CT imaging to predict bone fragility preoperatively may aid in assessing the risk of postoperative complications.https://doi.org/10.1177/21514593251361803 |
| spellingShingle | Daisuke Enomoto MD Hyonmin Choe MD, PhD Masahiro Matsumoto MD Koki Abe MD, PhD Kazuyoshi Yamamoto MD, PhD Kousuke Matsuo MD, PhD Hiroyuki Makita MD, PhD Naomi Kobayashi MD, PhD Yutaka Inaba MD, PhD CT-Based Evaluation of Bone Mineral Density Distribution of Proximal Femur in Patients With Femoral Trochanteric Fracture Geriatric Orthopaedic Surgery & Rehabilitation |
| title | CT-Based Evaluation of Bone Mineral Density Distribution of Proximal Femur in Patients With Femoral Trochanteric Fracture |
| title_full | CT-Based Evaluation of Bone Mineral Density Distribution of Proximal Femur in Patients With Femoral Trochanteric Fracture |
| title_fullStr | CT-Based Evaluation of Bone Mineral Density Distribution of Proximal Femur in Patients With Femoral Trochanteric Fracture |
| title_full_unstemmed | CT-Based Evaluation of Bone Mineral Density Distribution of Proximal Femur in Patients With Femoral Trochanteric Fracture |
| title_short | CT-Based Evaluation of Bone Mineral Density Distribution of Proximal Femur in Patients With Femoral Trochanteric Fracture |
| title_sort | ct based evaluation of bone mineral density distribution of proximal femur in patients with femoral trochanteric fracture |
| url | https://doi.org/10.1177/21514593251361803 |
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