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Review
. 2014 Sep 18;5(4):486-95.
doi: 10.5312/wjo.v5.i4.486.

Bone three-dimensional microstructural features of the common osteoporotic fracture sites

Affiliations
Review

Bone three-dimensional microstructural features of the common osteoporotic fracture sites

Huayue Chen et al. World J Orthop. .

Abstract

Osteoporosis is a common metabolic skeletal disorder characterized by decreased bone mass and deteriorated bone structure, leading to increased susceptibility to fractures. With aging population, osteoporotic fractures are of global health and socioeconomic importance. The three-dimensional microstructural information of the common osteoporosis-related fracture sites, including vertebra, femoral neck and distal radius, is a key for fully understanding osteoporosis pathogenesis and predicting the fracture risk. Low vertebral bone mineral density (BMD) is correlated with increased fracture of the spine. Vertebral BMD decreases from cervical to lumbar spine, with the lowest BMD at the third lumbar vertebra. Trabecular bone mass of the vertebrae is much lower than that of the peripheral bone. Cancellous bone of the vertebral body has a complex heterogeneous three-dimensional microstructure, with lower bone volume in the central and anterior superior regions. Trabecular bone quality is a key element to maintain the vertebral strength. The increased fragility of osteoporotic femoral neck is attributed to low cancellous bone volume and high compact porosity. Compared with age-matched controls, increased cortical porosity is observed at the femoral neck in osteoporotic fracture patients. Distal radius demonstrates spatial inhomogeneous characteristic in cortical microstructure. The medial region of the distal radius displays the highest cortical porosity compared with the lateral, anterior and posterior regions. Bone strength of the distal radius is mainly determined by cortical porosity, which deteriorates with advancing age.

Keywords: Cortical bone; Distal radius; Femoral neck; Fracture; Microstructure; Osteoporosis; Trabecular bone; Vertebra.

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Figures

Figure 1
Figure 1
The trabecular bone mineral density of the thoracic and lumbar vertebrae[22]. The bone mineral density tends to decrease from the first thoracic to third lumbar vertebra.
Figure 2
Figure 2
Micro-computed tomography image in different regions of vertebral body[25]. A: Anterosuperior; B: Anteroinferior; C: Central; D: Posterosuperior; E: Posteroinferior regions. The trabecular bone is lower in the anterosuperior and central regions.
Figure 3
Figure 3
Scanning electron microscopic image of vertebral trabecular bone[25]. The microcallus (MC) is seen on the vertical trabecula (A). Tertical trabeculae are relatively thicker than the horizontal ones (B).
Figure 4
Figure 4
Trabecular microstructure of femoral neck from a man aged 62 years (A), a man aged 92 years (B), a woman aged 62 years (C), and a woman aged 92 years (D)[49]. The trabecular bone is higher in a man aged 62 years and is lower in a woman aged 92 years.
Figure 5
Figure 5
Three D reconstructed images of the canal networks in the inferior femoral neck cortex from a man aged 62 years (A), a man aged 92 years (B), a woman aged 62 years (C), and a woman aged 92 years (D)[49]. There are more enlarged canals in the 92 years than those of the 62 years.

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