An experiment was designed to determine whether the material properties
of fracture callus can be predicted by the measurement of mineral density.
Rat tibiae that had a closed fracture were used to obtain uniform specimens
of fracture callus at sequential stages of healing. An in vitro indentation
test was done and tissue was biopsied, using a trephine, to determine the
hardness and calcium content of a standardized area of callus tissue. The
hardness of the callus was correlated with the mineral density of the local
tissue, which initially had been measured non-invasively with
single-photon-based micro-bone densitometry. The progress of
differentiation and remodeling of callus was determined by comparative
planimetric and microradiographic analyses of tissue. Determinations of
density showed a linear correlation with concentrations of a hydroxyapatite
equivalent solution (r = 0.997, p less than 0.001), with the ash weight of
control specimens of cortical-trabecular bone (r = 0.998, p less than
0.001), and with the calcium content (micrograms per cubic millimeter) of
the fracture callus (r = 0.854, p less than 0.001). The hardness of the
callus had a non-linear relationship (r = 0.959, p less than 0.005) with
the mineral density per volume of tissue, as measured by micro-bone
densitometry. Clinical Relevance: The appearance of fracture callus on
conventional radiographs is an important clinical finding in the assessment
of fracture-healing. It is, however, an unreliable predictor of the
strength of the union of the fracture. Three-dimensional imaging and
quantification of bone mineral provide additional data about the quality
and geometry of fracture callus. Our study showed that mineral content per
unit of volume is a good index of hardness of the fracture callus. Thus,
quantitative imaging may be useful clinically for monitoring
fracture-healing.