title: Fracture Repair in the Distal Radius in Postmenopausal Women: A Follow-Up 2 Years Postfracture Using HRpQCT.
abstract: Fracture healing is characterized by an intense increase in modeling and remodeling of bone, which allows removal of the cast after a stable distal radius fracture within 3 to 5 weeks. However, at that time, bone strength has not recovered yet. We studied the changes in bone mineral density (BMD), microarchitecture, and bone stiffness after a distal radius fracture during a 2-year follow-up in comparison to the contralateral side and the association between the 2-year stiffness and baseline BMD, microarchitecture, and early changes in these parameters. The fractured side of 14 postmenopausal women (mean age 64 ± 8 years) with a conservatively treated distal radius fracture was scanned by high-resolution peripheral quantitative computed tomography (HRpQCT) at 1 to 2, 3 to 4, 6 to 8, and 12 weeks and 2 years postfracture. The same region contralaterally was scanned as well at the 2-year visit. BMD, microarchitecture, and stiffness parameters were determined and the fracture side was compared with the contralateral side using a linear mixed-effect model. Spearman's correlation was used to correlate the 2-year bone stiffness with baseline BMD, microarchitecture, and early 3-month changes in these parameters. Two years postfracture, cortical and trabecular thickness and torsional and bending stiffness were significantly higher at the fractured side compared with the nonfractured side (21%, 55%, 31%, and 29%, respectively, p < 0.05), whereas BMD was similar. Two-year torsional and bending stiffness correlated significantly with baseline BMD and cortical perimeter (|rho| ≥ 0.63, p < 0.016) but not with early changes in bone parameters. Using HRpQCT, this study illustrates that fracture healing is not completed by the time the cast is removed. We showed that from 6 weeks to 2 years postfracture, large changes occur in BMD, microarchitecture, and biomechanical parameters at the fractured side, which were fully recovered after 2 years in comparison to the nonfractured contralateral side. Interestingly, higher 2-year torsional and bending stiffness were associated with lower BMD and higher cortical perimeter at baseline. © 2015 American Society for Bone and Mineral Research.
authors.affiliation: NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.|Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Joost J A
authors.initials: JJA
authors.lastname: de Jong
authors.affiliation: NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.|Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.|Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands.
authors.forename: Frans L
authors.initials: FL
authors.lastname: Heyer
authors.affiliation: Department of Orthopedic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.|CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Jacobus J C
authors.initials: JJC
authors.lastname: Arts
authors.affiliation: NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.|Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: Poeze
authors.affiliation: Department of Medical Informatics, Uniklinik RWTH Aachen University, Aachen, Germany.
authors.forename: András P
authors.initials: AP
authors.lastname: Keszei
authors.affiliation: Department of Orthopedic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.|CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Willems
authors.affiliation: Faculty of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
authors.forename: Bert
authors.initials: B
authors.lastname: van Rietbergen
authors.affiliation: Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.|CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, Maastricht, The Netherlands.|Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
authors.forename: Piet P
authors.initials: PP
authors.lastname: Geusens
authors.affiliation: NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.|Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.|Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands.|Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
authors.forename: Joop P W
authors.initials: JPW
authors.lastname: van den Bergh
mesh_terms: D000368:Aged; D015519:Bone Density; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000378:metabolism*; D011884:Radius / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology
keywords: DISTAL RADIUS; FRACTURE REPAIR; HRpQCT; POSTMENOPAUSAL WOMEN