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Determining whether
different fixation strategies can be tailored to a patient’s bone density for
optimizing their clinical outcomes is an important consideration for fracture
patients.
Clinical outcomes of
the fracture fixation treatment were significantly associated with bone
density, as per research of Archives
of Orthopaedic and Trauma Surgery journal. Osteoporosis and reduced bone density
is a severe condition that enhances the risk of fractures. The association
between the low bone density and fracture risk is well known, but the effects
of fracture risk on fracture fixation and related clinical outcomes are
unknown.
Therefore to determine
a relationship between clinical outcomes after fracture fixation and bone
quality, Stephen J. Warner and colleagues conducted a study with 64 patients
who got the ankle fracture fixation by the one surgeon from 2003 to 2013. A
preoperative and postoperative computed tomography (CT) imaging was done to
assess injured and contralateral ankle respectively. An elliptical region of interest that was
limited to the cancellous metaphyseal region of the distal fibula and tibia was
used to determine Hounsfield unit (HU) values. The Foot and Ankle Outcome
Scores (FAOS) and ankle range of motion (ROM) were used as primary and
secondary study outcomes. All the patients had the record of clinical outcome
data at least one year.
An almost perfect
agreement (ICC(2,1) = 0.938) was noticed from the comparison of injured and
contralateral HU values. As per the agreement, the HU values can be correctly
determined in the setting of a fracture. The improved outcomes in the four FAOS
domains; quality of life, pain, sports and activities of daily living showed a
significant association with the enhanced HU values of the fibula and distal
tibia (P ≤ 0.05). However, no significant relationship was noticed
between HU values and range of motion. According to results, the quality of
bones plays a very crucial role in the fracture fixation.
Archives of Orthopaedic and Trauma Surgery
Bone density correlates with clinical outcomes after ankle fracture fixation
Stephen J. Warner et al.
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