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Association Between Hounsfield Units in Preoperative Wrist Computed Tomography Scans and Outcomes After Wrist Fracture Surgery

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Abstract

Purpose

This work aims to evaluate the hypothesis that the value of Hounsfield units (HU), as a marker of bone density, in preoperative wrist computed tomography (CT) scans correlates with the functional outcomes as measured by patient reported outcomes (PROs) after distal radius fracture surgery with volar locking plate fixation.

Methods

Of a database of 92 wrist fractures operated on in our hospital between 2011 and 2020, with a preoperative CT scan performed, we selected the cases with a minimum follow-up period of 12 months. After applying the exclusion criteria, the final cohort comprised 64 patients. Three measurements of HU were performed in correlative coronal sections of the capitate bone. PROs were determined using two functional questionnaires (DASH and PRWE) and one quality of life questionnaire (SF-12). The statistical relationship between PROs and the HU measurements obtained via a CT scan was analyzed.

Results

Patients were classified into two groups, osteoporotic (OST) or non-osteoporotic (non-OST), according to the optimal cut-off value of 323 HU selected using a ROC curve. The median DASH questionnaire score in the OST group was significantly higher (1.7 vs 10.0, p = 0.003).

Conclusion

HU values in preoperative wrist CT scans may help to identify osteoporotic bone in patients prior to wrist fracture surgery and lead to an improved surgical indication and treatment strategy.

Level of Evidence

Level of evidence: Prognostic III.

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This manuscript has no associated data but they will be offered on request.

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Acknowledgements

We gratefully acknowledge Manuel Fuentes and Amanda López-Picado for their expert technical assistance and help with the statistical analysis.

Funding

No external funding was received for this investigation.

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Authors and Affiliations

  1. Hand and Wrist Surgery Unit, Orthopedic Surgery and Traumatology, Department, San Carlos Clinical Hospital, 5ª Planta, Ala Sur. Calle Profesor Martín Lagos S/N, 28004, Madrid, Spain

    María-José Pérez-Úbeda, Belén Rizo, Alicia Collado-Gosálvez, María-Dolores Gimeno & Fernando Marco-Martinez

  2. Radiology Department, San Carlos Clinical Hospital, Madrid, Spain

    Alejandro Urbina-Balanz

  3. Surgery Department, Complutense University of Madrid, Madrid, Spain

    Fernando Marco-Martinez

Authors
  1. María-José Pérez-Úbeda
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  2. Alejandro Urbina-Balanz
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  3. Belén Rizo
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  4. Alicia Collado-Gosálvez
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  5. María-Dolores Gimeno
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  6. Fernando Marco-Martinez
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Contributions

Reporting guidelines: The authors have adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

Corresponding author

Correspondence to María-José Pérez-Úbeda.

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Neither the authors, their immediate family members, or any research foundation with which they are affiliated have received any remuneration or other benefits from any commercial entity related to the subject of this article.

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This study was approved by the local Research Ethics Committee.

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For this type of study, formal consent is not required. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.

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Pérez-Úbeda, MJ., Urbina-Balanz, A., Rizo, B. et al. Association Between Hounsfield Units in Preoperative Wrist Computed Tomography Scans and Outcomes After Wrist Fracture Surgery. JOIO 56, 2141–2152 (2022). https://doi.org/10.1007/s43465-022-00749-7

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  • DOI: https://doi.org/10.1007/s43465-022-00749-7

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