Healing of distal radius assessed by high resolution CT

Joost de Jong

Distal radius fractures are the most common fractures that are seen at the emergency department of a hospital. In clinical practise, the healing process of these fractures in monitored using plain radiography (X-rays) in combination with physical examination by the treating physician. Unfortunately, such 2D X-rays do not provide information about the consolidation of the fine trabecular network and neither about the recovery of the bone biomechanical properties.

Recently, a high resolution peripheral quantitative computed tomography (HRpQCT) scanner was developed, which allows assessment of the bone’s micro-architecture in vivo in patients. Whereas most studies use this scanner to study the effect of medication or disease on unfractured bone, my research is focussed on exploring the possibilities of this technique to monitor the healing process of fractured bone in patients with a distal radius fracture.

Using HRpQCT, we have shown that during the healing process of these fractures large changes occur in bone mineral density and micro-architecture of both the trabecular as well as the cortical region. Furthermore, micro-finite element analysis (µFEA) based on these HRpQCT images revealed that bone stiffness is not yet restored by the time the cast is removed.

Currently, my research is focussed on analysing the sites of bone formation and resorption (both concurrently occur during the healing process), which requires accurate registration of the HRpQCT images over each other.