Application of hounsfield units of the distal fibula in evaluating bone mineral density of geriatric ankle fracture

Objective Ankle fracture is a common type of fracture with increasing incidence in recent years. It is mainly caused by osteoporosis and has not attracted much attention. This study aimed to measure the Hounsfield units (HU) of the distal fibula by computed tomography (CT) scans, evaluate the bone mineral density (BMD) in patients with ankle fracture, and explore the correlation between BMD and ankle fracture. Methods We enrolled 74 patients with ankle fracture and divided them into osteoporosis, osteopenia, and normal groups according bone density. The examiners measured the HU of the distal fibula and we analysis calculated the best HU to distinguish group differences using the receiver operating characteristic (ROC) curve and analyzed the correlation between HU of the distal fibula and BMD, and T-score of lumbar vertebrae and the proximal femur. Results The HU of the distal fibula was significantly associated with whole parts except BMD of total lumbar, especially with BMD of L2, which had the highest correlation (r=0.555, P