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Archives of Orthopaedic and Trauma Surgery

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01-06-2015 | Trauma Surgery

Is the cortical thickness index a valid parameter to assess bone mineral density in geriatric patients with hip fractures?

Authors: Ralf Baumgärtner, Nickolaus Heeren, Daniel Quast, Reto Babst, Alexander Brunner

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2015

Abstract

Introduction

Reduced bone quality is a common problem during surgical fixation of geriatric hip fractures. The cortical thickness index (CTI) was proposed to assess the bone mineral density (BMD) of the proximal femur on the basis of plain X-rays. The purpose of this study was to evaluate the inter- and intraobserver reliability of the CTI and to investigate correlation between CTI and BMD in geriatric patients.

Methods

60 patients (20 pertrochanteric fractures, 20 femoral neck fractures, 20 without fractures) were included. All patients had ap and lateral hip X-rays and measurement of BMD by Dual Energy X-ray Absorptiometry at different areas of the hip. The ap and lateral CTI was measured twice by four blinded observers and correlation between mean CTI and BMD was calculated.

Results

Mean ap CTI was 0.52 and mean lateral CTI was 0.45. Inter- and intraobserver reliability was good for ap CTI (ICC 0.71; 0.79) and lateral CTI (ICC 0.65; 0.69). A significant correlation between CTI and overall BMD was found in patients without fractures (r = 0.74; r = 0.67). No significant correlation between CTI and overall BMD was found in patients with proximal femoral fractures.

Conclusion

The CTI has sufficient reliability for the use in daily practice. It showed significant correlation with BMD in patients without hip fractures. In patients with proximal femoral fractures, no correlation between CTI and BMD was found. We do not recommend the CTI as parameter to assess the BMD of the proximal femur in geriatric patients with hip fractures.

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Title: Is the cortical thickness index a valid parameter to assess bone mineral density in geriatric patients with hip fractures?
Authors: Ralf Baumgärtner
Nickolaus Heeren
Daniel Quast
Reto Babst
Alexander Brunner
Publication date: 01-06-2015
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 6/2015
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-015-2202-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Is the cortical thickness index a valid parameter to assess bone mineral density in geriatric patients with hip fractures?

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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