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Spatial distribution of hip cortical thickness in postmenopausal women with different osteoporotic fractures

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Abstract

Summary

Few studies h ave discussed the association between cortical bone outside the fracture site and the fracture itself. Focusing on hip cortical thickness, this study revealed distinct distributions of the parameters for hip (trochanteric or femoral neck), vertebral, and peripheral osteoporotic fractures and suggested that the spatial distribution of hip cortical thickness was fracture-specific.

Purpose

Cortical bone is critical for bone strength. Hip cortical thickness is reported to be closely associated with the incidence of hip fractures, but its relationship with nonhip fractures is rarely studied. As the hip is a major site for fracture risk assessment, it would be of great benefit to investigate the association between hip cortical thickness and different osteoporotic fractures.

Methods

One hundred age-matched postmenopausal women were equally assigned to 4 osteoporotic fracture groups (trochanteric, femoral neck, vertebral, and peripheral fractures) and a nonfracture group. Each subject had a clinical quantitative computed tomography scan of the bilateral hips and the lumbar spine. A cortical bone map** algorithm was adopted to calculate hip cortical thickness. Hip and lumbar trabecular density and the hip cortical thickness distribution were compared among the groups.

Results

All the fracture groups presented lower lumbar trabecular density. Compared with nonfracture controls, patients with hip or vertebral fractures but not peripheral fractures showed decreased cortical thickness and trabecular density of the hip. Fracture-specific distributions of cortical thickness were revealed, including zonal defects on the neck-intertrochanter junction, greater trochanter, and the periphery of the lesser trochanter for trochanteric fractures, a focal defect on the anterosuperior neck for femoral neck fractures, a moderate and average distribution for vertebral fractures, and focally thicker cortices on the anterosuperior greater trochanter and the periphery of the lesser trochanter for peripheral fractures.

Conclusion

The spatial distribution of hip cortical thickness was different for each type of osteoporotic fracture, and patients with centrally located fractures demonstrated more severe cortical deterioration. This finding needs to be validated in a larger sample.

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Availability of data and materials

The data are available from the corresponding author on reasonable request.

Code availability

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Funding

Science and Technology Commission of Shanghai Municipality (15411951500) and Foundation of Shanghai Municipal Commission of Health and Family Planning (2015ZB0501).

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Authors and Affiliations

  1. Department of Orthopaedics, Huadong Hospital Affiliated to Fudan University, Shanghai, China

    Ming Ling, **anlong Li, Yueyang Xu & Yongqian Fan

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  1. Ming Ling
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  2. **anlong Li
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Contributions

ML was responsible for data analysis, data interpretation, manuscript drafting, and revision; XL and YX were responsible for data collection and preprocessing; YF was responsible for study design and manuscript revision.

Corresponding author

Correspondence to Yongqian Fan.

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The study was approved by Ethical Committee of Huadong Hospital Affiliated to Fudan University.

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Informed consent was obtained from all individual participants included in the study.

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None.

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Ling, M., Li, X., Xu, Y. et al. Spatial distribution of hip cortical thickness in postmenopausal women with different osteoporotic fractures. Arch Osteoporos 16, 172 (2021). https://doi.org/10.1007/s11657-021-01039-9

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