Association between femur size and a focal defect of the superior femoral neck.

Abstract:

:Within each sex, there is an association between hip fracture risk and the size of the proximal femur, with larger femurs apparently more susceptible to fracture. Here, we investigate whether the thickness and density of the femoral cortex play a role in this association: might larger femurs harbour focal, cortical defects? To answer this question, we used cortical bone mapping to measure the distribution of cortical mass surface density (CMSD, mg/cm(2)) in cohorts of 308 males and 125 females. Principal component analysis of the various femoral surfaces led to a measure of size that is linearly independent from shape. After mapping the data onto a canonical femur surface, we used statistical parametric mapping to identify any regions where CMSD depends on size, allowing for other confounding covariates including shape. Our principal finding was a focal patch on the superior femoral neck, where CMSD is reduced by around 1% for each 1% increase in proximal-distal size (p<0.000005 in the males, p<0.001 in the females). This finding appears to be consistent with models of functional adaptation, and may help with the design of interventional strategies for reducing fracture risk.

journal_name

Bone

journal_title

Bone

authors

Gee AH,Treece GM,Tonkin CJ,Black DM,Poole KES

doi

10.1016/j.bone.2015.06.024

subject

Has Abstract

pub_date

2015-12-01 00:00:00

pages

60-66

eissn

8756-3282

issn

1873-2763

pii

S8756-3282(15)00261-6

journal_volume

81

pub_type

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