Effects of long-term immobilisation on cortical bone mass after traumatic amputation of the phalanges estimated by digital X-ray radiogrammetry

Osteoporos Int. 2008 Sep;19(9):1291-9. doi: 10.1007/s00198-008-0570-x. Epub 2008 Feb 26.

Abstract

Osteopenia of the cortical and trabecular bone partition is a common finding after immobilisation. Digital X-ray radiogrammetry (DXR) seems to quantify cortical demineralisation caused by circular saw amputation already few days after accident.

Introduction: The study analyses the extent of demineralisation caused by immobilisation in patients with digital amputation after a circular saw injury, and elucidates the period of time which discloses a significant deprivation of bone mineral density estimated at the metacarpalia II-IV using DXR.

Methods: Twenty-eight patients with digital amputations underwent measurements of bone mineral density, cortical thickness, bone width and metacarpal index using DXR-technology in a follow-up up to 902 days.

Results: The data showed a significant decline of bone mineral density (-10.47%), the metacarpal index (-4.38%), the bone width (-12.06%) and the cortical thickness (-7.04%) after trauma-related amputation. The cortical demineralisation of the metacarpals could already be revealed in two patients after the second day, according to the amputation of phalanges (-3.65%).

Conclusions: The inhibition of the periosteal bone formation detected by DXR-technique seems to be a specific finding caused by amputation, which thus differs from normal age-related (i.e., endosteal) bone loss and from demineralisation following acute immobilisation (i.e., trabecular osteopenia).

MeSH terms

  • Absorptiometry, Photon / methods
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Amputation, Traumatic / complications*
  • Amputation, Traumatic / diagnostic imaging
  • Amputation, Traumatic / physiopathology
  • Bone Density*
  • Bone Diseases, Metabolic / diagnostic imaging
  • Bone Diseases, Metabolic / etiology*
  • Bone Diseases, Metabolic / physiopathology
  • Finger Injuries / complications*
  • Finger Injuries / diagnostic imaging
  • Finger Injuries / physiopathology
  • Finger Phalanges / diagnostic imaging
  • Finger Phalanges / physiopathology*
  • Humans
  • Immobilization / physiology
  • Longitudinal Studies
  • Middle Aged
  • Young Adult