Microarchitecture of the radial head and its changes in aging.

Department of Trauma, Hand, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
Calcified Tissue International (Impact Factor: 2.75). 11/2009; 86(1):14-22. DOI: 10.1007/s00223-009-9304-0
Source: PubMed

ABSTRACT Fractures of the radial head are common; however, it remains to be determined whether the radial head has to be considered as a typical location for fractures associated with osteoporosis. To investigate whether the human radial head shows structural changes during aging, we analyzed 30 left and 30 right human radial heads taken from 30 individuals. The specimens taken from the left side were analyzed by peripheral quantitative computed tomography (pQCT) and micro-CT. The specimens taken from the right elbow joint were analyzed by radiography and histomorphometry. In these specimens pQCT revealed a significant decrease of total and cortical bone mineral density (BMD(to) BMD(co)) with aging, regardless of sex. Histomorphometry revealed a significant reduction of cortical thickness (Ct.Th), bone volume per tissue volume (BV/TV), and trabecular thickness (Tb.Th) in male and female specimens. In this context, mean BV/TV and mean trabecular number (Tb.N) values were significantly lower and, accordingly, mean trabecular separation (Tb.Sp) was significantly higher in female samples. The presented study demonstrates that the radial head is a skeletal site where different age- and sex-related changes of the bone structure become manifest. These microarchitectural changes might contribute to the pathogenesis of radial head fractures, especially in aged female patients where trabecular parameters (BMD(tr) and Tb.Sp) change significantly for the worse compared to male patients.

Download full-text


Available from: Frank Timo Beil, Mar 03, 2014
1 Follower
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Radial head fractures are commonly interpreted as isolated injuries, and it is assumed that the energy transferred during trauma has its influence on the risk on associated ipsilateral upper limb injuries. However, relationships between Mason classification, mechanism of injury, and associated injuries have been reported only once before in a relatively small population. The purpose of this study was to define whether trauma mechanism and patient related factors are of influence on the type of radial head fracture and associated injuries to the ipsilateral upper limb in 440 patients. Methods The radiographs and medical records of 440 patients that presented with a fracture of the radial head were retrospectively analyzed. The medical records of all patients were searched for (1) the trauma mechanism and (2) associated injuries of the ipsilateral upper limb. The mechanism of injury was classified as being low-energy trauma (LET) or high-energy trauma (HET). Results Associated injuries to the ipsilateral upper limb were present in 46 patients (11 %). The mean age of patients with associated injuries (52 years) was significantly higher compared to patients without associated injuries (47 years) (P = 0.038), and female patients with a radial head fracture were older than males. Injury patterns were classified as LET in 266 patients (60 %) and as HET in 174 patients. HETs were significantly more common in young men. Associated injuries were not significantly different distributed between HET versus LET (P = 0.82). Conclusions Injuries concomitant to radial head fractures were present in 11 % of patients and the risk for these associated injuries increases with age. Trauma mechanism did not have a significant influence on the risk of associated injuries. Complex elbow trauma in patients with a radial head fracture seems therefore to be suspected based on patient characteristics, rather than mechanism of injury.
    BMC Musculoskeletal Disorders 06/2015; 16. DOI:10.1186/s12891-015-0603-5 · 1.90 Impact Factor
  • Source
    Journal of Hard Tissue Biology 01/2014; 23(2):267-274. DOI:10.2485/jhtb.23.267 · 0.28 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Fractures of the radial head are common with most partial articular fractures resulting in an anterolateral fragment. The exact mechanism of radial head fracture is unknown; however, forces transmitted and variations in local bone density are believed important. This study quantifies the regional variations in bone density and volume of the radial head to better understand the pathomechanics of fracture patterns.Methods Computer tomography scan data of 18 cadaver elbows were imported into imaging analysis software. The radial head was divided into quadrants based on neutral forearm rotation. Bone density and volume were calculated and compared between quadrants.ResultsThe regional densities of bone expressed in Hounsfield units (HU) were posteromedial quadrant (PM) 496 ± 87 HU, anteromedial quadrant (AM) 443 ± 72 HU, anterolateral quadrant (AL) 409 ± 60 HU, and posterolateral quadrant (PL) 406 ± 57 HU. The volume of bone in descending order was PM 1138 ± 179 mm3, PL 1013 ± 213 mm3, AM 1010 ± 210 mm3, and AL 938 ± 175 mm3. The PM quadrant was significantly denser than the AM, AL, and PL quadrants, (P = .001) and the AM quadrant was significantly denser than the AL and PL quadrants (P = .006 and .009). The PM quadrant had significantly more bone volume when compared to the AM, AL, and PL (P = .001). The AM and PL quadrants had significantly greater bone volume compared to AL quadrant (P = .023 and .018, respectively).Conclusion Radial head bone volume and density is highest in the posteromedial quadrant and lowest in the anterolateral quadrant where fractures occur more frequently.
    Journal of Shoulder and Elbow Surgery 12/2012; 21(12):1669-1673. DOI:10.1016/j.jse.2012.07.002 · 2.37 Impact Factor