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The cortical thickness of the proximal humeral diaphysis predicts bone mineral density of the proximal humerus

Orthopaedic Biomechanics Laboratory, Beth Israel Deaconess Medical Centre, Harvard Medical School, 330 Brookline Avenue, RN115 Boston, Massachusetts 02215, USA.

D. Zurakowski, PhD

300 Longwood Avenue, Boston, Massachusetts 02115, USA.

J. J. P. Warner, MD

275 Cambridge Street, Suite 403, Boston, Massachusetts 02114-3130, USA.

Correspondence should be sent to Dr M. Apreleva.

The operative treatment of fractures of the proximal humerus can be complicated by poor bone quality. Our aim was to evaluate a new method which allows prediction of the bone quality of the proximal humerus from radiographs.

Anteroposterior radiographs were taken of 19 human cadaver humeri. The cortical thickness was measured at two levels of the proximal humeral diaphysis. The bone mineral density (BMD) was determined for the humeral head (HH), the surgical neck (SN), the greater tuberosity (GT) and lesser tuberosity (LT) using dual-energy x-ray absorptiometry.

The mean cortical thickness was 4.4 ± 1.0 mm. Specimens aged 70 years or less had a significantly higher cortical thickness than those aged over 70 years. A significant positive correlation was found between cortical thickness and the BMD for each region of interest.

The cortical thickness of the proximal diaphysis is a reliable predictor of the bone quality of the proximal humerus.