Osteoporotic fractures are now a social problem for incidence
and costs. Fractures of the proximal humerus events are frequent
and constantly increasing. It is estimated that they are
20% of all osteoporotic fractures. Bone densitometry in most
cases underestimates the real humeral bone density.
There is little information about osteoporotic changes in the
proximal humerus and their association with the cortical thickness
of the humeral shaft. The ratio between the thickness
of the cortical and the total diameter of the humeral diaphysis
is the cortical index. Fracture risk limit value is 0.231.
Convinced of the need to quantify in a reproducible way the
real local humerus bone density, we performed a comparative
evaluation of bone density of the humerus and femur in
patients admitted to our clinic for fractures of the humerus
and femur.
We evaluated 28 women treated surgically for a fragility fracture
of the proximal humerus or femur neck in 2010. All cortical
index obtained were lower than the limit for fracture risk
set at 0.231, so the IC was more predictive of neck medial fractures
of the femur than had DEXA and the U.S. The information
about the cortical index may provide a simple way of determining
the bone quality of the proximal humerus and of facilitating
decision-making in the surgical treatment of patients
with fractures of the humerus. So we want to emphasize the
importance of therapy for osteoporosis even in patients with
fractures of the proximal humerus, which often have not critical
densitometric values of femur or column, but they are
at risk of new fractures