Evaluation of the First Metacarpal Bone Head and Distal Radius Bone Architecture Using Fractal Analysis of Adolescent Hand–Wrist Radiographs

The purpose of this study was to investigate changes in bone trabecular structure during adolescence using the fractal analysis (FA) method on hand–wrist radiographs (HWRs) and to evaluate the relationship of these changes with pubertal growth stages. HWRs of healthy individuals aged 8–18 years were...

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Main Authors: Kader Azlağ Pekince, Adem Pekince
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Journal of Imaging
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Online Access:https://www.mdpi.com/2313-433X/11/3/82
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author Kader Azlağ Pekince
Adem Pekince
author_facet Kader Azlağ Pekince
Adem Pekince
author_sort Kader Azlağ Pekince
collection DOAJ
description The purpose of this study was to investigate changes in bone trabecular structure during adolescence using the fractal analysis (FA) method on hand–wrist radiographs (HWRs) and to evaluate the relationship of these changes with pubertal growth stages. HWRs of healthy individuals aged 8–18 years were included (<i>N</i> = 600). Pubertal stages were determined by the Fishman method and divided into 10 groups (early puberty [EP], pre-peak [PRPK], peak [PK], post-peak [PTPK], late puberty [LP]). FA was performed using FIJI (ImageJ) software and the BoneJ plugin on circular regions of interest (ROIs) selected from the first metacarpal bone head and distal radius. Image processing steps were applied according to the White and Rudolph method. Differences between groups were statistically evaluated. Fractal dimension (FD) values of the distal radius (RAFAM) and metacarpal bone head (MAFAM) showed significant differences according to pubertal growth stages (<i>p</i> < 0.05). The highest FD value was observed in the LP group, and the lowest FD value was observed in the EP group (except MAFAM in females). FD generally increased from EP to LP in the whole population, but a significant decrease was observed in all groups during the PK period. This decrease was more pronounced in RAFAM of males. These findings suggest a potential decrease of bone mechanical properties in the PK, which is found the be more suitable for orthodontic treatment in the literature. FA on HWRs is a useful and sensitive tool for quantitatively assessing pubertal changes in trabecular bone microarchitecture. The findings demonstrate a significant decrease in FD in both bone regions during the pubertal growth spurt, particularly at the peak period. This may indicate a temporary reduction in bone mechanical strength during this critical stage and could contribute to increased distal radius fracture incidence. Clinically, the relationship between FD and pubertal stages suggests this method could serve as a valuable biomarker in orthodontic treatment planning, allowing for optimized timing of interventions. Furthermore, it may aid in pediatric fracture risk assessment, potentially leading to preventative strategies for high-risk individuals.
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spelling doaj-art-95fa070adda54a22879ec1bdfe5e19c02025-08-20T02:11:26ZengMDPI AGJournal of Imaging2313-433X2025-03-011138210.3390/jimaging11030082Evaluation of the First Metacarpal Bone Head and Distal Radius Bone Architecture Using Fractal Analysis of Adolescent Hand–Wrist RadiographsKader Azlağ Pekince0Adem Pekince1Department of Oral and Maxillofacial Radiology, Karabük University, Karabük 78000, TürkiyeDepartment of Oral and Maxillofacial Radiology, Karabük University, Karabük 78000, TürkiyeThe purpose of this study was to investigate changes in bone trabecular structure during adolescence using the fractal analysis (FA) method on hand–wrist radiographs (HWRs) and to evaluate the relationship of these changes with pubertal growth stages. HWRs of healthy individuals aged 8–18 years were included (<i>N</i> = 600). Pubertal stages were determined by the Fishman method and divided into 10 groups (early puberty [EP], pre-peak [PRPK], peak [PK], post-peak [PTPK], late puberty [LP]). FA was performed using FIJI (ImageJ) software and the BoneJ plugin on circular regions of interest (ROIs) selected from the first metacarpal bone head and distal radius. Image processing steps were applied according to the White and Rudolph method. Differences between groups were statistically evaluated. Fractal dimension (FD) values of the distal radius (RAFAM) and metacarpal bone head (MAFAM) showed significant differences according to pubertal growth stages (<i>p</i> < 0.05). The highest FD value was observed in the LP group, and the lowest FD value was observed in the EP group (except MAFAM in females). FD generally increased from EP to LP in the whole population, but a significant decrease was observed in all groups during the PK period. This decrease was more pronounced in RAFAM of males. These findings suggest a potential decrease of bone mechanical properties in the PK, which is found the be more suitable for orthodontic treatment in the literature. FA on HWRs is a useful and sensitive tool for quantitatively assessing pubertal changes in trabecular bone microarchitecture. The findings demonstrate a significant decrease in FD in both bone regions during the pubertal growth spurt, particularly at the peak period. This may indicate a temporary reduction in bone mechanical strength during this critical stage and could contribute to increased distal radius fracture incidence. Clinically, the relationship between FD and pubertal stages suggests this method could serve as a valuable biomarker in orthodontic treatment planning, allowing for optimized timing of interventions. Furthermore, it may aid in pediatric fracture risk assessment, potentially leading to preventative strategies for high-risk individuals.https://www.mdpi.com/2313-433X/11/3/82fractal analysisbone microarchitecture (or trabecular bone)pubertal development (or skeletal maturation)hand–wrist radiographsadolescents
spellingShingle Kader Azlağ Pekince
Adem Pekince
Evaluation of the First Metacarpal Bone Head and Distal Radius Bone Architecture Using Fractal Analysis of Adolescent Hand–Wrist Radiographs
Journal of Imaging
fractal analysis
bone microarchitecture (or trabecular bone)
pubertal development (or skeletal maturation)
hand–wrist radiographs
adolescents
title Evaluation of the First Metacarpal Bone Head and Distal Radius Bone Architecture Using Fractal Analysis of Adolescent Hand–Wrist Radiographs
title_full Evaluation of the First Metacarpal Bone Head and Distal Radius Bone Architecture Using Fractal Analysis of Adolescent Hand–Wrist Radiographs
title_fullStr Evaluation of the First Metacarpal Bone Head and Distal Radius Bone Architecture Using Fractal Analysis of Adolescent Hand–Wrist Radiographs
title_full_unstemmed Evaluation of the First Metacarpal Bone Head and Distal Radius Bone Architecture Using Fractal Analysis of Adolescent Hand–Wrist Radiographs
title_short Evaluation of the First Metacarpal Bone Head and Distal Radius Bone Architecture Using Fractal Analysis of Adolescent Hand–Wrist Radiographs
title_sort evaluation of the first metacarpal bone head and distal radius bone architecture using fractal analysis of adolescent hand wrist radiographs
topic fractal analysis
bone microarchitecture (or trabecular bone)
pubertal development (or skeletal maturation)
hand–wrist radiographs
adolescents
url https://www.mdpi.com/2313-433X/11/3/82
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