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Abstract
Year 2021
October 2021

SHBC1607

Abstract Title
UTILITY OF THE DELTOID TUBEROSITY INDEX IN THE PROXIMAL HUMERAL FRACTURES IN THE ASIAN POPULATION
Authors

W.X.NG1

Institutions

Tan Tock Seng Hospital1

Background & Hypothesis

The poor local bone mineral density (BMD) in the proximal humeral fracture (PHF) can often make surgical fixation challenging and increase failure rates. The radiographically measured deltoid tuberosity index (DTI) defined by Spross et al (2015) found strong correlations with local proximal humeral BMD and a predictor of secondary displacement in non-operative patients, by Frank et al (2020). Our study investigates the inter-rater and intra-rater reliability of DTI and the correlation between DTI and BMD.

Methods

This was a cross-sectional study with retrospective review of electronic records of patients with PHF in a single hospital in Singapore. After ethics approval, we reviewed parameters such as gender, age and dual energy x-ray absorptiometry (DEXA) BMD measurements. DTI was assessed on anterior-posterior shoulder radiographs of the injured shoulder by 4 trained observers.

Results

Eighty-seven patients, consisting 69 women and 18 men were recruited. Mean age was 69.7 (SD 9.52, range 39 to 92) years, mean DTI was 1.49, mean T score was -2.27 and -1.38 for femoral neck and lumbar spine on the DEXA BMD. Both the estimated intra-rater (correlation coefficient >0.80) and inter-rater reliability of DTI (intraclass correlation coefficient 0.898; 95% CI 0.784 -0.950) were considered to be good. Moderately good to poor correlations (0.40-0.580) were observed between the DTI and BMD after age and gender adjustment, with the highest correlation with the femoral neck density.

Discussion & Conclusion

The DTI is a simple and reliable tool to assess local BMD at different levels of training, but may not be useful in predicting systemic osteoporosis.

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