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Human bone material characterization: integrated imaging surface investigation of male fragility fractures

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Abstract

Summary

The interrelation of calcium and phosphorus was evaluated as a function of bone material quality in femoral heads from male fragility fracture patients via surface analytical imaging as well as scanning microscopy techniques. A link between fragility fractures and increased calcium to phosphorus ratio was observed despite normal mineralization density distribution.

Introduction

Bone fragility in men has been recently recognized as a public health issue, but little attention has been devoted to bone material quality and the possible efficacy in fracture risk prevention. Clinical routine fracture risk estimations do not consider the quality of the mineralized matrix and the critical role played by the different chemical components that are present. This study uses a combination of different imaging and analytical techniques to gain insights into both the spatial distribution and the relationship of phosphorus and calcium in bone.

Methods

X-ray photoelectron spectroscopy and time-of-flight secondary ion mass spectrometry imaging techniques were used to investigate the relationship between calcium and phosphorus in un-embedded human femoral head specimens from fragility fracture patients and non-fracture age-matched controls. The inclusion of the bone mineral density distribution via backscattered scanning electron microscopy provides information about the mineralization status between the groups.

Results

A link between fragility fracture and increased calcium and decreased phosphorus in the femoral head was observed despite normal mineralization density distribution. Results exhibited significantly increased calcium to phosphorus ratio in the fragility fracture group, whereas the non-fracture control group ratio was in agreement with the literature value of 1.66 M ratio in mature bone.

Conclusions

Our results highlight the potential importance of the relationship between calcium and phosphorus, especially in areas of new bone formation, when estimating fracture risk of the femoral head. The determination of calcium and phosphorus fractions in bone mineral density measurements may hold the key to better fracture risk assessment as well as more targeted therapies.

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Acknowledgements

The authors would like to thank the staff of the Department of Orthopaedics and Trauma in the Royal Adelaide Hospital and the mortuary staff of SA Pathology, Adelaide for the collection of femoral and autopsy specimens. Furthermore, the authors acknowledge the facilities and scientific and technical assistance of the Australian Microscopy & Microanalysis Research Facility. This work was supported by a grant from the Australian Research Council (DP0878419).

Conflicts of interest

None.

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Authors and Affiliations

  1. School of Chemical and Physical Sciences, Flinders University, GPO Box 2100, Bedford Park, Adelaide, SA, 5042, Australia

    R. Zoehrer, J. G. Shapter & N. H. Voelcker

  2. Bone and Joint Research Laboratory, Surgical Pathology, SA Pathology and Hanson Institute, Frome Road, Adelaide, SA, 5000, Australia

    E. Perilli, J. S. Kuliwaba & N. L. Fazzalari

  3. Discipline of Anatomy and Pathology, The University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia

    E. Perilli, J. S. Kuliwaba & N. L. Fazzalari

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  1. R. Zoehrer
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  2. E. Perilli
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  4. J. G. Shapter
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  5. N. L. Fazzalari
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  6. N. H. Voelcker
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Correspondence to N. H. Voelcker.

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Zoehrer, R., Perilli, E., Kuliwaba, J.S. et al. Human bone material characterization: integrated imaging surface investigation of male fragility fractures. Osteoporos Int 23, 1297–1309 (2012). https://doi.org/10.1007/s00198-011-1688-9

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  • DOI: https://doi.org/10.1007/s00198-011-1688-9

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