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Title: Femoral neck fragility in women has its structural and biomechanical basis established by periosteal modeling during growth and endocortical remodeling during aging.
Austin Authors: Filardi, Silvana;Zebaze, Roger Martin Djoumessi;Duan, Yunbo;Edmonds, Jan;Beck, Thomas J;Seeman, Ego 
Affiliation: Austin and Repatriation Medical Centre, University of Melbourne, Heidelberg, 3084, Melbourne, Australia
Issue Date: 7-Nov-2003
Publication information: Osteoporosis International : A Journal Established As Result of Cooperation Between the European Foundation For Osteoporosis and the National Osteoporosis Foundation of The Usa 2003; 15(2): 103-7
Abstract: To gain insight into the growth- and age-related origins of bone fragility at the proximal femur, we analyzed structural and biomechanical data of the femoral neck from a study of postmenopausal women with hip fractures and their 47 premenopausal daughters. Results were expressed as standard deviations (SD) or Z-scores (mean +/- SEM) adjusted for age and weight, derived using a normal reference population of 262 premenopausal women and 370 postmenopausal women. Women with hip fractures had increased femoral neck (FN) periosteal and endocortical diameters (1.01 +/- 0.26 SD and 1.18 +/- 0.25 SD, respectively). Cortical thickness was reduced by 0.96 +/- 0.1 SD and volumetric bone mineral density (vBMD) was reduced by 1.2 +/- 0.1 SD). The section modulus was normal while the buckling ratio was increased by 1.59 +/- 0.17 SD). Their daughters had increased FN diameter by about one half that of their mothers (0.48 +/- 0.16 SD), while endocortical diameter was increased by only one third (0.44 +/- 0.13 SD). Cortical thickness and vBMD were not reduced, the section modulus was increased (0.48 +/- 0.13 SD) while the buckling ratio was normal. We infer that the larger femoral neck size in women with hip fractures is growth-related; the wider endocortical cavity and thinner cortex is the result of excessive age-related endocortical bone resorption producing a thin cortex in a larger bone predisposing to structural failure by local buckling. The structural basis of bone fragility has some features originating during growth and others during aging.
Gov't Doc #: 14605802
DOI: 10.1007/s00198-003-1539-4
Journal: Osteoporosis International
Type: Journal Article
Subjects: Adult
Aged, 80 and over
Biomechanical Phenomena
Bone Density
Bone Resorption.physiopathology
Femur Neck.growth & development.pathology.physiopathology
Hip Fractures.genetics.pathology.physiopathology
Middle Aged
Periosteum.growth & development.physiology
Appears in Collections:Journal articles

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