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

María-José Pérez-Úbeda; Alejandro Urbina-Balanz; Belén Rizo; Alicia Collado-Gosálvez; María-Dolores Gimeno; Fernando Marco-Martinez

doi:10.1007/s43465-022-00749-7

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

Indian J Orthop. 2022 Sep 19;56(12):2141-2152. doi: 10.1007/s43465-022-00749-7. eCollection 2022 Dec.

Authors

María-José Pérez-Úbeda¹, Alejandro Urbina-Balanz², Belén Rizo¹, Alicia Collado-Gosálvez¹, María-Dolores Gimeno¹, Fernando Marco-Martinez^{1

3}

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.
² Radiology Department, San Carlos Clinical Hospital, Madrid, Spain.
³ Surgery Department, Complutense University of Madrid, Madrid, Spain.

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.

Keywords: Computed tomography; Hounsfield unit; Osteoporosis; Outcomes; Wrist fracture surgery.

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