Three-dimensional distribution of trabecular bone density and cortical thickness in the distal humerus.
BACKGROUND
One major barrier to osteosynthesis in distal humeral fractures is poor bone quality. This study was an attempt to measure the bone quality in the distal humerus.


METHODS
We measured the distribution of total bone mineral density (BMD), trabecular BMD (tBMD), and cortical thickness (CTh) in the distal humerus using peripheral quantitive computed tomography. Four slices in the infracondylar, supracondylar, and distal disphyseal regions of 25 human cadaver humeri were investigated.


RESULTS
Total BMD decreased continuously from the distal diaphysis to the trochlea. Within the infracondylar region, the capitellum was the region of lowest tBMD and CTh (P < .001). Measurements in anterior regions were higher than in most others (P < .001). The tBMD of the medial column in the infracondylar and supracondylar regions was 31% and 36% higher vs the lateral column (P < .001). The medial column had an average 22% higher CTh in the supracondylar and 38% higher CTh in distal diaphyseal regions vs the lateral sides (P < .001).


CONCLUSIONS
Distal humeral bone properties vary widely, providing stronger bone stock on the medial side. This may improve understanding of implant failure and techniques in surgical treatment.
Diederichs
Gerd
G
Institute of Radiology, Charité-Universitätsmedizin Berlin, Humboldt University of Berlin, Berlin, Germany. gerd.diederichs@charite.de
Issever
Ahi-Sema
AS
Greiner
Stefan
S
Linke
Berend
B
Korner
Jan
J
D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology*; D002102:Cadaver; D016001:Confidence Intervals; D018483:Diaphyses / Q000000981:diagnostic imaging / Q000473:pathology; D004551:Elbow Joint / Q000473:pathology; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D006810:Humeral Fractures / Q000473:pathology / Q000601:surgery; D006811:Humerus / Q000000981:diagnostic imaging* / Q000473:pathology*; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011336:Probability; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D000092464:Elbow Injuries