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Osteoporosis International
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Open Access 21-03-2022 | Osteoporosis | Original Article

Bone material strength index as measured by in vivo impact microindentation is normal in subjects with high-energy trauma fractures

Authors: M. Schoeb, E. M. Winter, F. Malgo, I. B. Schipper, R. J. P. van der Wal, S. E. Papapoulos, N. M. Appelman-Dijkstra

Published in: Osteoporosis International | Issue 7/2022

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Abstract

Summary

Bone material properties were assessed using impact microindentation in patients with high-energy trauma fractures. Compared to patients with low-energy trauma fractures, bone material strength index was significantly higher in patients with high-energy trauma fractures, and did not differ between patients with osteopenia and those with osteoporosis within each trauma group.

Introduction

Impact microindentation (IMI) is a technique to assess tissue-level properties of bone at the tibia. Bone material strength index (BMSi), measured by IMI, is decreased in patients with low-energy trauma fractures, independently of areal bone mineral density (aBMD), but there is no information about BMSi in patients with high-energy trauma fractures. In the present study, we evaluated tissue-level properties of bone with IMI in patients with high-energy trauma fractures.

Methods

BMSi was measured 3.0 months (IQR 2.0–5.8) after the fracture in 40 patients with high-energy trauma and 40 age- and gender-matched controls with low-energy trauma fractures using the OsteoProbe® device.

Results

Mean age of high- and low-energy trauma patients was 57.7 ± 9.1 and 57.2 ± 7.7 years, respectively (p = 0.78). Fracture types were comparable in high- vs low-energy trauma patients. Lumbar spine (LS)-aBMD, but not femoral neck (FN)-aBMD, was higher in high- than in low-energy trauma patients (LS 0.96 ± 0.13 vs 0.89 ± 0.13 g/cm2, p = 0.02; FN 0.75 ± 0.09 vs 0.72 ± 0.09 g/cm2, p = 0.09). BMSi was significantly higher in high- than in low-energy trauma patients (84.4 ± 5.0 vs 78.0 ± 4.6, p = 0.001), also after adjusting for aBMD (p = 0.003). In addition, BMSi did not differ between patients with osteopenia and those with osteoporosis within each trauma group.

Conclusion

Our data demonstrate that BMSi and LS-aBMD, but not FN-aBMD, are significantly higher in high-energy trauma patients compared to matched controls with similar fractures from low-energy trauma. Further studies of non-osteoporotic patients with high-energy trauma fracture with measurements of BMSi are warranted to determine whether IMI might help in identifying those with reduced bone strength.
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Metadata
Title
Bone material strength index as measured by in vivo impact microindentation is normal in subjects with high-energy trauma fractures
Authors
M. Schoeb
E. M. Winter
F. Malgo
I. B. Schipper
R. J. P. van der Wal
S. E. Papapoulos
N. M. Appelman-Dijkstra
Publication date
21-03-2022
Publisher
Springer London
Published in
Osteoporosis International / Issue 7/2022
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-022-06368-0

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