Can CT Bone Density Predict Fracture Healing? Clinical and Radiological Correlation of Hounsfield Units in Distal Radius Fractures

Introduction Distal radius fractures are among the most common osteoporotic fractures, particularly in middle-aged. Accurate assessment of bone quality plays a crucial role in treatment planning and predicting outcomes. Hounsfield Unit (HU) values derived from computed tomography (CT) scans have been proposed as a practical tool for evaluating regional bone mineral density. This study aimed to investigate the relationship between HU values measured in preoperative CT scans and postoperative clinical and radiological outcomes in patients with distal radius fractures. Methods A retrospective analysis was conducted on 59 patients aged 18-65 who underwent surgical treatment for distal radius fractures. HU values were measured from the metaphyseal region of the distal radius using axial CT images. Fractures were classified according to the AO classification system. Clinical outcomes were evaluated using the Modified Mayo Wrist Score (MMWS), and union times were recorded. Statistical analyses included Spearman correlation and Kruskal-Wallis tests. Results No significant differences were found between fracture types (AO classification) and HU values, union times, or wrist scores (p > 0.05). However, a statistically significant moderate negative correlation was observed between HU values and fracture union time (p < 0.05), indicating that lower bone density was associated with delayed healing. Conclusion While HU values did not correlate with fracture pattern or functional outcomes, they were associated with fracture healing time. Given their accessibility, low cost, and absence of additional radiation exposure, HU measurements from routine CT scans may serve as a practical tool for assessing bone quality and predicting healing potential in distal radius fractures.