Metacarpal Radiogrammetry Research Articles

Decreased bone mass in adolescents with bone fragility fracture but not in young children: a case-control study.

The incidence of distal forearm fracture due to minimal/moderate trauma shows a bimodal distribution for age at event, with one peak occurring during early adolescence, in both boys and girls and the other one in postmenopausal females. The aim of this study was, therefore, to document whether the relationship between bone mineral density and fracture is different in young children compared with adolescents. A matched-pair, case-control study has been conducted to evaluate bone mineral density in 469 young children and 387 adolescents of both sexes, with/without fracture due to minimal/moderate trauma with assurance that the compared groups were equally susceptible to the outcome event. All fractures were radiographically confirmed. The study utilized bone mineral areal density of the total body, spine, hips, and forearm; volumetric bone mineral density of the forearm; and metacarpal radiogrammetry measurements. The study controlled for skeletal development, bone geometry, body composition, hand grip strength, calcium intake, and vitamin D status. Adolescents with distal forearm fracture have reduced bone mineral density at multiple skeletal regions of interest. This was documented by the bone mineral areal density measurements at multiple skeletal sites (p < 0.001), volumetric bone mineral density measurements of the forearm (p < 0.0001), and metacarpal radiogrammetry (p < 0.001). Adolescent females with fracture had reduced cross-sectional areas of the radius and metacarpals. The bone status of young female and male children with fracture was no different to its controls. Increased body fatness was more prevalent among fracture cases than in controls. Around 72% of young female and male children with fracture had serum 25-hydroxyvitamin D levels below the threshold of 31 ng/ml, compared with only 42% of female controls and to 51% of male controls. Adolescents with bone fragility fracture had reduced bone mineral density at multiple skeletal regions of interest, whereas this was not the case with younger children. The results of the study may have implications for the prevention of bone fragility in this segment of the pediatric population.

Exploring radiogrammetry beyond the second metacarpal: Using the third, fourth, and fifth metacarpals to quantify cortical bone.

Traditional metacarpal radiogrammetry, a method for quantifying cortical bone in metacarpals to identify bone loss, typically relies on the presence of an unaltered or undamaged second metacarpal. This study compares the cortical indices of the second to the third, fourth, and fifth metacarpals to test if an additional metacarpal can be used as substitute when the second metacarpal is not available for study. Hand and wrist radiographs from the Burlington Growth Study, belonging to 56 individuals (28 females; 28 males) between 18 and 20 years old, were included in this study. Cortical indices were calculated for metacarpals two through five. Cortical index differences were statistically compared by sex, and the second metacarpal cortical indices were correlated with those of the third, fourth, and fifth metacarpals. The third, fourth, and fifth metacarpal cortical indices were all significantly correlated with the second metacarpal cortical indices for both females and males (p <.05). Cortical indices of the second metacarpal were most strongly correlated with those of the third metacarpal (females r =.644, p <.001; males r=.643, p < .001). The results of this study indicate that the third, fourth, or fifth metacarpal may serve as substitutes for cortical index analyses when the second metacarpal is unavailable or unsuitable for analysis. While the second metacarpal should remain the primary choice in radiogrammetry analyses, the third metacarpal is the most suitable alternative for quantitative analyses of cortical bone.

Cortical bone maintenance and loss in Colonial Mexico City: Analysis of sex‐ and age‐related differences

AbstractPrevious research has demonstrated significant age‐ and sex‐related differences in bone loss in European populations. This study utilizes metacarpal radiogrammetry to analyze cortical bone thickness and bone loss for a sample of indigenous individuals (n = 120) from the Hospital Real San José de los Naturales (HSJN) skeletal collection in Colonial Mexico City. The results indicate statistically significant differences between males and females in total length, total width, and cortical thickness, but no difference in the standardized cortical index measure. There are significant differences in age groups for all measures except total length and the population follows a similar pattern of decreased cortical index over the life course. When age and sex are considered together, females begin this bone loss from young to middle adulthood with continued loss in old adulthood; however, males do not see a decrease in cortical index until old adulthood. While these results are consistent with previously reported patterns of bone loss, the HSJN population has higher levels of peak cortical bone in young adulthood than any archeological European populations. We suggest that this increased peak bone mass may reflect differences in diet that include higher levels of calcium and magnesium as a result of the traditional practice of softening corn by boiling it in limewater (nixtamalization). Similarly, a small sample of African descendant individuals (n = 5) from the HSJN population was compared with the averages for indigenous individuals in the collection and indicated a variation in bone size, though predominantly higher levels of cortical index that may also suggest important population differences that should be further explored. This research provides important comparative data on bone maintenance and loss that supports previous hypotheses that a higher nutrient diet in modern populations may be the key factor in increased peak bone mass compared with archeological populations.

Quantifying cortical bone in fragmentary archeological second metacarpals.

Skeletal variation in cortical bone thickness is an indicator of bone quality and health in archeological populations. Second metacarpal radiogrammetry, which measures cortical thickness at the shaft midpoint, is traditionally used to evaluate bone loss in bioarcheological and some clinical contexts. However fragmentary elements are regularly omitted because the midpoint cannot be determined. This methodological limitation reduces sample sizes and biases them against individuals prone to fracture, such as older individuals with low bone mass. This study introduces a new technique for measuring cortical bone in second metacarpals, the "Region of Interest" (ROI) method, which quantifies bone in archeological remains with less-than-ideal preservation while accounting for cortical heterogeneity. The ROI method was adapted from digital X-ray radiogrammetry (DXR), a clinical method used to estimate bone mineral density, and tested using second metacarpals from Middenbeemster, Netherlands, a 19th century known age and sex skeletal collection. The ROI method quantifies cortical bone area within a 1.9 cm-long, mid-diaphyseal region, standardized for body size differences using total area (CAIROI ). CAIROI values were compared to traditional radiogrammetric cortical indices (CI) to assess the method's ability to identify age-related bone loss. CAIROI values have high intra- and interobserver replicability and are strongly and significantly correlated with CI values for both males (r[n = 39] = 0.906, p = 0.000) and females (r[n = 58] = 0.925, p = 0.000). The ROI method complements traditional radiogrammetry analyses and provides a reliable way to quantify cortical bone in incomplete second metacarpals, thereby maximizing sample sizes, allowing patterns in bone acquisition and loss to be more comprehensively depicted in archeological assemblages.

Automated bone age measure and metacarpal radiogrammetry versus traditional methods.

Automated bone age measure and metacarpal radiogrammetry versus traditional methods.

Metacarpal Indices and Their Association with Fracture in South African Children and Adolescents.

This prospective study assessed whether metacarpal indices predict fracture risk in children and adolescents. Radiogrammetry was performed at the second metacarpal midshaft on annual hand-wrist radiographs of 359 South African (SA) children aged 10-17years. Bone length, bone width, and medullary width were measured, and the following proxies for bone strength calculated:metacarpal index (MCI), bone mineral density (BMD), section modulus (SM), stress-strain index (SSI), and slenderness index (SLI). Height and weight were measured annually. Self-reported physical activity (PA) and fracture history were obtained at ages 15years (for the preceding 12months) and 17years, respectively. At 17 years, 82 (23%) participants (black, 16%; white, 42%; p < 0.001) reported a previous fracture. None of the bone measures or indices were associated with fracture in black participants. In white females, after adjusting for PA, a 1 standard deviation (SD) greater SLI doubled the fracture risk [odds ratio (OR) 2.08; 95% confidence interval (CI) 1.08, 3.98]. In white males, a 1 SD greater BMD was associated with a 2.62-fold increase in fracture risk (OR 3.62; 95% CI 1.22, 10.75), whilst a 1 SD greater SM (OR 2.29; 95% CI 1.07, 4.89) and SSI (OR 2.23; 95% CI 1.11, 4.47) were associated with a more than twofold increase in fracture risk, after height, and PA adjustment. No single index consistently predicted fracture across the four groups possibly due to ethnic and sex differences in bone geometry, muscle mass, and skeletal loading. Metacarpal radiogrammetry did not reliably predict fracture in SA children.

IGFALS Gene Dosage Effects on Serum IGF-I and Glucose Metabolism, Body Composition, Bone Growth in Length and Width, and the Pharmacokinetics of Recombinant Human IGF-I Administration

Acid labile subunit (ALS) deficiency, caused by IGFALS mutations, is a subtype of primary IGF-I deficiency (PIGFD) and has been associated with insulin resistance (IR) and osteopenia. Whether patients respond to recombinant human IGF-I (rhIGF-I) is unknown. This study determined the 14-hour pharmacokinetic response of free and total IGF-I and IGF binding protein 3 (IGFBP-3) to a single sc dose of rhIGF-I (120 μg/kg) in four ALS-deficient patients, compared with severe PIGFD, moderate PIGFD, and controls. Intravenous glucose tolerance tests, fasting blood levels, dual-energy X-ray absorptiometry, peripheral quantitative computed tomography, and metacarpal radiogrammetry were performed in the four patients and 12 heterozygous family members. IGF-I and IGFBP-3 increased above baseline (P < .05) for 2.5 hours, returning to baseline 7 hours after rhIGF-I injection. Mean (SD) IGF-I Z-score increased by 2.49 (0.90), whereas IGFBP-3 Z-score increased by 0.57 (0.10) only. IGF-I elimination rates in ALS deficiency were similar, but the IGF-I increment was lower than those for severe PIGFD. Significant gene dosage effects were found for all IGF-I peptides, height, forearm muscle size, and metacarpal width. Bone analysis showed that ALS deficiency creates a phenotype of slender bones with normal size-corrected density. Abnormal glucose handling and IR was found in three of four patients and 6 of 12 carriers. These gene dosage effects demonstrate that one functional IGFALS allele is insufficient to maintain normal ALS levels, endocrine IGF-I action, full growth potential, muscle size, and periosteal expansion. Similar gene dosage effects may exist for parameters of IR. Despite similar IGF-I elimination compared with severe PIGFD, ALS-deficient patients cannot mount a similar response. Alternative ways of rhIGF-I administration should be sought.

An investigation of cortical bone loss and fracture patterns in the neolithic community of Çatalhöyük, Turkey using metacarpal radiogrammetry

Bioarchaeologists have conducted numerous studies on human skeletal remains using metacarpal cortical bone radiogrammetry. This method allows cortical thickness of the second metacarpal to be quantified. As a sensitive index of bone health metacarpal cortical thickness is evaluated in the context of functional adaptations, growth, ageing and bone loss in osteoporosis, as well as used as a reliable indicator of fracture risk. The focus of this study is an examination of the widely used calculation that expresses second metacarpal cortical bone values, followed by an examination of age and sex-related patterns of cortical bone loss and skeletal fragility fracture in a Neolithic archaeological skeletal sample from Çatalhöyük, Turkey. Using metacarpal radiogrammetry, 49 adult metacarpals ( f = 27 m = 22) were examined. Data were collected for size variables, length (L) and total bone width (TW) as well as quantity variables, medullary width (MW) and cortical thickness (CT). These parameters were then used to calculate the widely used cortical index (CI) and two new indices expressing medullary width and cortical bone thickness in relation to length (medullary width index, MWI and cortical thickness index, CTI). The ratios were then used to explore age- and sex-related cortical bone loss and fragility fracture patterns amongst the inhabitants of Çatalhöyük. Çatalhöyük males and females demonstrate an inverse relationship where CTI decreases as age and MWI increase. Analyses indicate statistically significant age-related change in MWI amongst the oldest females. Despite age-related loss of bone, no typical fragility fractures are observed. We discuss the role of ageing and lifestyle factors at Çatalhöyük that may have been beneficial to skeletal health and a reduction in the risk of fragility fracture.

THE CLASSIC: Quantitative Computed Tomography of Vertebral Spongiosa: A Sensitive Method for Detecting Early Bone Loss after Oophorectomy

THE CLASSIC: Quantitative Computed Tomography of Vertebral Spongiosa: A Sensitive Method for Detecting Early Bone Loss after Oophorectomy

Age‐related cortical bone loss in women from a 3rd–4th century AD population from England

Age-dependent cortical bone loss in adult females from a skeletal assemblage from 3rd-4th century AD England was studied using metacarpal radiogrammetry. Results showed reduced peak cortical bone thickness compared with modern subjects, and the magnitude of cortical bone loss in older females compared with their younger counterparts was greater than that documented for a modern reference population. An elevated prevalence of fractures classically associated with osteoporosis was also observed in the over-50-year cohort. The severity of osteoporosis in this group is difficult to explain in terms of extraneous factors relating to 3rd-4th century lifestyles. Given the important genetic component in osteoporosis, the results may indicate some inherent susceptibility in this particular population to the disease, and ways in which this possibility might be further explored are suggested.

Metacarpal radiogrammetry: a useful indicator of bone loss throughout the skeleton?

Metacarpal radiogrammetry has received increasing interest in recent studies of archaeological human bone in facilitating the identification of age-related cortical bone loss and osteoporosis risk in the past. The technique is relatively simple and non-destructive, and existing comparative clinical data is an advantage in its application to archaeological samples. In order for metacarpal radiogrammetry to be useful in identifying individuals that could have been at risk of fracture in the past, cortical bone loss as measured at the second metacarpal is assumed to be reflective of bone loss occurring throughout the skeleton and across the metabolically different cortical and trabecular bone. Archaeological studies have frequently relied on literature reviews of clinical data to justify the technique as valid and useful. However, the present study has examined whether cortical bone loss measured in the second metacarpal is similar to bone loss measured at specific skeletal sites that are more frequently affected by osteoporosis-related fracture. Skeletons from two post-medieval collections from London, UK, Redcross Way and Farringdon Street (lower burial ground of St. Bride's Church) were studied. The results of the present study demonstrate that the second metacarpal is useful in identifying age-related bone loss at sites that are predilected to osteoporotic fracture, most notably the distal radius, which is prone to Colles' fractures. Metacarpal radiogrammetry also correlates well with bone loss in skeletal sites that are primarily composed of trabecular bone, including the fourth lumbar vertebra (a site of compression fractures) and the iliac crest (the location for clinical biopsies). The present study also confirms previous findings of significant differences between the pattern of cortical bone loss between the metacarpal and the femur. The poor relationship between these two areas is most likely attributable to mechanical loading.

Bone mass in Chinese premenarcheal girls: the roles of body composition, calcium intake and physical activity

The association of growth and anthropometric characteristics and lifestyle factors with bone mass and second metacarpal radiogrammetry parameters was evaluated in 373 healthy Chinese premenarcheal girls aged 9-11 years. Bone mineral content (BMC) and density (BMD) and bone area (BA) of distal forearm, proximal forearm and total body, bone mineral-free lean (BMFL) mass and fat mass were measured by dual-energy X-ray absorptiometry. Metacarpal bone periosteal and medullary diameters were measured. Dietary intakes were assessed by 7 d food record and physical activity (PA) by questionnaire. BMFL and fat mass together explained 6.3 and 51.6% of the variation in total body BMC and BMD, respectively. BMFL mass contributed to a substantial proportion of the variation in forearm BMC and BMD and periosteal diameter (10.4-41.0%). The corresponding BA explained 14.8-80.4% of the variation in BMC. Other minor but significant predictors of total body bone mass were Ca intake, height, age and PA score (BMD only), and of forearm bone mass were PA score, bone age, height and fat mass. Nevertheless, after adjusting for bone and body size and for age or bone age, subjects with Ca intake above the median (417 mg/d) had 1.8% greater total body BMC (P<0.001), and subjects with PA scores above the median had 2.4-2.5% greater distal and proximal forearm BMC (P<0.05) than those below. Vitamin D intake negatively associated with medullary diameter (partial R2 1.7%). The results indicate that premenarcheal girls should be encouraged to optimise nutrition and Ca intake and exercise regularly to achieve maximum peak bone mass.

A procedural guide to metacarpal radiogrammetry in archaeology

AbstractThe technique of metacarpal radiogrammetry was devised in 1960 as a clinical method to aid in the identification of thinned cortical bone, which may help in diagnosis of osteoporosis. Through taking measurements from radiographs, calculations of the amount of cortical bone can be made. The technique is relatively simple and is not destructive. This paper examines the value of the application of this technique to archaeological remains. A standardized methodology of bone assessment is incorporated to enhance the comparability of future research. Statistical tests demonstrate that the technique is robust, as the position of the bone on the film, radiographic enlargement and use of either the left or right metacarpal will not affect the results obtained. However, differences in film type and measurement position can introduce unacceptable variance into the results. Therefore, guidance is given on future applications of the technique. The technique does have value as a widely available, non‐destructive technique for assessing cortical bone loss and the probable prevalence of osteoporosis in archaeological collections. Copyright © 2004 John Wiley &amp; Sons, Ltd.

Prediction of cross-sectional geometry from metacarpal radiogrammetry: a validation study.

Regression models have been developed to adjust algebraic estimates of second metacarpal cortical bone geometry to actual values (as determined through invasive analysis). These models, derived from an archaeological sample of European origin, have high efficacy in predicting actual values but have not been validated on non-European samples. This paper reports a validation study for these models applied to a historic/proto-historic sample of Inuit from the central Canadian Arctic (n = 166; ages and sexes pooled as per the original study). In that the Inuit sample has been argued to exhibit distinct skeletal biology, this represents a robust test of the predictive models. The algebraic models again produced biased overestimates of actual values, whereas the predictive regression models were found to provide good estimates of actual values for measures of bone strength (Total Area, bending about the Ix and Iy axes), but not for estimates of mass (Cortical Area). This difference may exist in either functional or systemic differences in skeletal physiology and aging bone loss in the Inuit.

Effects of age and occupation on cortical bone in a group of 18th-19th century British men.

The effects of age and occupation on cortical bone in a group of adult males from the 18th-19th century AD skeletal collection from Christ Church Spitalfields, London, were investigated. Cortical bone was monitored using metacarpal radiogrammetry. Individual age at death was known exactly from coffin plates. Occupation for individuals was known from historical sources. Results showed that continued periosteal apposition was evident throughout adult life, but from middle age onwards this was outstripped by about 2:1 by endosteal resorption, so that there was net thinning of cortical bone. The rate of cortical thinning resembled that seen in modern European males. Cross-sectional properties, as measured by second moments of area, bore no relationship to occupation. The results may suggest that, firstly, patterns of loss of cortical bone have remained unchanged in males for at least two centuries in Britain, and secondly, that biomechanical analyses of metacarpal cortical bone may be rather insensitive indicators of intensity of manual activity.

Evaluation of osteoporosis using conventional radiographic methods and dual energy x‐ray absorptiometry

In India, conventional radiographs play a major part in evaluating osteoporosis since advanced bone densitometers are expensive and not widely available. Our aim in this study was to investigate the usefulness of conventional radiographic methods, viz., clavicle and metacarpal radiogrammetry, quantitative vertebral morphometry, Singh's index, hip geometry compared to a sophisticated method, viz., DXA for studying osteoporosis in south Indian men (n=663) and women (n=741). This study provides data on BMD of the proximal femur in normal south Indian females. In women, aged above 65 years, BMD of femoral neck, trochanter, and Ward's triangle decreased by 0.90%, 0.84%, and 1.66% per annum, respectively. In 45 pre‐ and post‐menopausal women without fractures, total hip BMD correlated significantly (p&lt;0.001) with Singh's index medial cortical thickness of the femoral shaft and neck combined cortical thickness (CCT) and %CCT of the clavicle each), and the second metacarpal and respectively). On comparing variables studied for osteoporotic women with corresponding values in the premenopausal group, the average difference in SD from the mean was greatest for clavicle radiogrammetry (−3.7 SD for %CCT of the clavicle). An empirical formula for predicting total hip BMD with good sensitivity was derived from a multiple linear regression equation involving three independent variables, viz., CCT, %CCT of the clavicle (measured from the chest radiograph) and the patient's age. This author's equation, with modified weightings, has 82% sensitivity and 94% specificity and a positive and negative predictive value of 88% and 91% respectively. A chest radiograph in combination with the formula would serve as a readily available, inexpensive tool for assessing post‐menopausal osteoporosis, especially in developing countries.

Quantitative computed tomography of vertebral spongiosa: a sensitive method for detecting early bone loss after oophorectomy. 1982.

We assessed serially the bone mineral loss in 37 premenopausal women for 24 months after oophorectomy and determined the dose-response for conjugated estrogen therapy in preventing this loss. Spinal cancellous bone was measured by quantitative computed tomography and measurement of appendicular cortical bone by radial photon absorptiometry and metacarpal radiogrammetry. For the placebo and low-dose treatment groups, the mean annual bone mineral losses were 7% to 9% from the vertebral spongiosum and 1% to 3% from the peripheral cortex. The correlation between axial and appendicular loss was weak (r = 0.581), precluding a reliable estimate of spinal loss from peripheral measurements. For the maximal-dose group (0.6 mg/d), the mean annual bone mineral losses were less than 0.5% from the axial and appendicular sites, and were not significant. The results indicate that spinal quantitative computed tomography provides a highly sensitive measurement of bone mineral loss after oophorectomy, that bone mineral loss is five- to sevenfold greater from the spinal spongiosum than from the appendicular cortex, and that conjugated estrogen in doses of less than 0.6 mg/d are inadequate to prevent the vertebral mineral loss.

Age-dependent cortical bone loss in women from 18th and early 19th century London.

Age-dependent cortical bone loss was investigated in an earlier British population. The study sample comprised female skeletons from the 18th/19th century crypt at Christ Church, Spitalfields, London. Bone loss was monitored using metacarpal radiogrammetry. Age at death was known exactly from coffin plates. Results indicated that peak cortical thickness was less than in modern subjects. Continuing periosteal apposition was evident throughout adulthood, and the rate of increase in metacarpal diameter resembled that in modern subjects. Bone loss from the endosteal surface was evident from the fifth decade onwards, and this outstripped the rate of subperiosteal gain so that there was a net loss of cortical bone with age. Cortical bone loss occurred at a similar rate to that in modern subjects. In contrast to modern populations, there was no evidence that loss of cortical bone was associated with increased propensity to fracture. The present results, together with those previously published for a British medieval skeletal assemblage, suggest that patterns of cortical bone loss in women have remained unchanged over at least the last millennium in Britain. Given the great changes in lifestyle which have occurred during this period, this suggests that lifestyle factors may be rather less important than is sometimes asserted in influencing the severity of osteoporosis, at least as far as loss of cortical bone is concerned.

Progression of aortic calcification is associated with metacarpal bone loss during menopause: a population-based longitudinal study.

offerosclerosis and osteoporosis are major causes of morbidity and mortality in postmenopausal women and have been suggested to be associated. No study has examined whether progression of atherosclerotic calcification is associated with bone loss. In the present study, we examined progression of aortic calcification, diagnosed by radiographic detection of calcified deposits in the abdominal aorta, in relation to metacarpal bone loss, as assessed by metacarpal radiogrammetry, during menopause. Initially premenopausal women (n=236), aged 45 to 57 years at baseline, were followed for 9 years. We additionally assessed the cross-sectional association between the extent of aortic calcification and metacarpal bone mass and density in 720 postmenopausal women. Twenty-five percent of women going through menopause showed progression of aortic calcification. The average loss of metacarpal bone mass among women with progression of aortic calcification was 3.2 mm(2), and their loss of metacarpal bone density was 7.2 mm(2) %, whereas in women without progression of aortic calcification, these losses were 2.0 mm(2) and 5.6 mm(2) %, respectively, adjusted for age and years of follow-up (P<0.05). Additional adjustment for age at menopause, body mass index, blood pressure, smoking, diabetes mellitus, and use of hormone replacement therapy, thiazide, and loop diuretics did not influence these results. In postmenopausal women, a graded inverse cross-sectional association between the extent of aortic calcification and metacarpal bone mass and density was found. In conclusion, our results indicate that progression of atherosclerotic calcification is associated with increased bone loss in women during menopause.

Metacarpal radiogrammetry by computed radiography in postmenopausal women with Colles' fracture and vertebral crush fracture syndrome.

Based on the hypothesis that the underlying osteoporotic mechanism of Colles' fracture in postmenopausal women is similar to that of other osteoporotic fractures, that is, cortical bone resorption as opposed to cancellous bone resorption, the rate of corticoendosteal bone loss was compared in 40 normal postmenopausal women [average age 68.4 +/- 7.1 years; 20 +/- 4 years since menopause (YSM)], in 35 postmenopausal women with Colles' fracture (age 69.4 +/- 7.5 years, 22 +/- 8 YSM), in 35 normal postmenopausal women with vertebral crush fracture (age 69.4 +/- 7.5 years, 22 +/- 8 YSM, and in 35 normal premenopausal women (age 36.1 +/- 7.9 years). Radiogrammetry by digital radiography of the second metacarpal was used to measure external (ED) and internal (ID) diameter, cortical thickness (CCT), cortical area (CA), and the ratio of cortical area to total area (CA/TA). The ID values of the groups of postmenopausal women were subtracted from the ID value of the premenopausal women and the result was divided by YSM to obtain the rate of corticoendosteal resorption/year (DeltaC), CA resorption year (DeltaCA) and CA/TA resorption/year (DeltaCA/TA). ID, DeltaC, DeltaCA, and DeltaCA/TA all were larger in the postmenopausal women with Colles' and vertebral crush fractures than in the normal postmenopausal women (ANOVA: all P < 0.0001). ID, CCT, DeltaC, CA, DeltaCA, and DeltaCA/TA did not differ between the two groups of postmenopausal women with fractures. DeltaC was 87% greater in postmenopausal women with vertebral crush fracture and 116% greater in women with Colles' fracture than in normal postmenopausal women. These results indicate that the loss of cortical bone is an important factor in Colles' fracture in postmenopausal women.