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. 2024 Oct 30:22925503241292351.
doi: 10.1177/22925503241292351. Online ahead of print.

Bone Mineral Density in the Scaphoid

Gokce Yildiran  1   2 , Tugba Gun Koplay  3 , Hande Akdeniz  1 , Zekeriya Tosun  1 , Ahmet Kagan Karabulut  2
Affiliations

Bone Mineral Density in the Scaphoid

Gokce Yildiran et al. Plast Surg (Oakv). .

Abstract
in English, French

Introduction: The scaphoid bone is essential for wrist stability and movement. While fractures commonly occur at the scaphoid's waist, those at the proximal pole, though rarer, tend to result in nonunion, potentially linked to variations in bone mineral density (BMD). Previous studies have shown an increase in BMD at the proximal pole in fractured scaphoids, but BMD distribution in intact scaphoids has not been well studied. This study aims to map the BMD distribution of the intact scaphoid to better understand the etiology of fractures and optimize treatment approaches. Methods: Conducted under ethical approval, this study included 100 individuals, using computed tomography to assess the BMD in distal, middle, and proximal thirds of the scaphoid. Measurements were performed in the defined regions and analyzed using SPSS software, with significance accepted at P < .05. Results: The study comprised 34 females and 66 males, with no significant BMD difference between the right and left wrists. The proximal third exhibited significantly higher BMD (542.2 HU) compared to the middle (293.1 HU) and distal thirds (298.4 HU). A statistically significant higher BMD was observed in males, particularly in the proximal and distal thirds. A weak negative correlation between age and BMD was noted across all sections. Conclusion: The proximal scaphoid shows significantly higher BMD, potentially explaining its lower fracture incidence but higher nonunion rate. This insight into the BMD distribution within an intact scaphoid may guide the clinical management of scaphoid fractures, highlighting the need for targeted treatment strategies based on BMD variations.

Introduction : L’os scaphoïde est essentiel pour la stabilité et le mouvement du poignet. Les fractures sont fréquentes au corps du scaphoïde, mais celles du pôle proximal, plus rares, ont tendance à ne pas se consolider, probablement à cause de variations de la densité minérale osseuse (DMO). Des études antérieures ont démontré un accroissement de la DMO au pôle proximal de scaphoïdes fracturés, mais la distribution de la DMO dans les scaphoïdes intacts n’a pas fait l’objet d’études approfondies. La présente étude vise à cartographier la distribution de la DMO du scaphoïde intact pour mieux comprendre l’étiologie des fractures et optimiser les approches thérapeutiques. Méthodologie : Réalisée sous approbation éthique, la présente étude faisait appel à la tomodensitométrie pour évaluer la DMO des tiers distal, médian et proximal du scaphoïde auprès de 100 personnes. Les mesures ont été effectuées dans des régions définies, puis ont été analysées à l’aide du logiciel SPSS, la signification était acceptée à P < 0,05. Résultats : L’étude était composée de 34 femmes et de 66 hommes, sans différence significative de la DMO entre le poignet droit et le poignet gauche. Le tiers proximal présentait une DMO beaucoup plus élevée (5422 UH) que les tiers médian (2931 UH) et distal (2984 UH). La DMO était statistiquement plus élevé chez les hommes, particulièrement dans le tiers proximal et le tiers distal. Une faible corrélation négative entre l’âge et la DMO était constatée dans toutes les sections. Conclusion : La DMO du scaphoïde proximal est considérablement plus élevée, ce qui explique peut-être son incidence de fracture plus faible, mais son taux plus élevé de non-consolidation. Cet aperçu de la distribution de la DMO dans un scaphoïde intact peut orienter la prise en charge clinique des fractures du scaphoïde, ce qui fait ressortir la nécessité de formuler des stratégies thérapeutiques d’après les variations de la DMO.

Keywords: bone mineral density; proximal pole; scaphoid; wrist fractures.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Graphical abstract
Graphical abstract
This is a visual representation of the abstract.
Figure 1.
Figure 1.
The PACS system was used to determine the thirds of the scaphoid through reference lines.
Figure 2.
Figure 2.
Measurement of the density of the distal third of the scaphoid in the axial section.
Figure 3.
Figure 3.
Measurement of the density of the middle third of the scaphoid in the sagittal section.
Figure 4.
Figure 4.
Measurement of the density of the proximal third of the scaphoid in the coronal section.
See this image and copyright information in PMC

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