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

• Published in: Osteoporosis international Vol. 33; no. 7; pp. 1511 - 1519
• Main Authors: Schoeb, M., Winter, E. M., Malgo, F., Schipper, I. B., van der Wal, R. J. P., Papapoulos, S. E., Appelman-Dijkstra, N. M.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.07.2022; Springer Nature B.V
• Subjects: Bone mineral density; Bone strength; Endocrinology; Energy; Fractures; Medicine; Medicine & Public Health; Original; Original Article; Orthopedics; Osteopenia; Osteoporosis; Rheumatology; Spine (lumbar); Tibia; Trauma; Traumatic fracture; Bone material properties; Osteoporosis; Bone quality; Bone strength; Fragility fracture
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-022-06368-0

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/cm 2 , p  = 0.02; FN 0.75 ± 0.09 vs 0.72 ± 0.09 g/cm 2 , 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.