Document Detail


Structure of the femoral neck in hip fracture: cortical bone loss in the inferoanterior to superoposterior axis.
MedLine Citation:
PMID:  9893072     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although bone mass is a contributory risk factor for hip fracture, its distribution about the femoral neck is also important. Femoral neck biopsies were obtained from 13 females with intracapsular hip fracture (fracture: mean age 74.3 +/- 2.3 years [SEM]) and 19 cadaveric samples (control: 9 males and 10 females 79.4 +/- 1.7 years) and the areas of cortical and cancellous bone were quantitated in octants. In the control group, although males had larger bones than females, the proportions of cortical and cancellous bone were not different (p > 0.05) between the genders. The total amount of bone, as a proportion of bone + marrow, was significantly reduced in the fractures compared with the female controls (%Tt.Ar: fracture 27.83 +/- 1.18, female control 33.62 +/- 1.47; p = 0.0054). Reductions in cortical bone area occurred in all regions but particularly in the inferior, inferoanterior, and anterior octants (p < 0.05). There were no differences between cases and controls in the regional amount of cancellous bone (all regions, p > 0.178). Marked reductions in mean cortical bone width between the fracture and female control group occurred in the anterior, inferoanterior (31%), and superoposterior (25%) regions. Representing cortical widths as simple Fourier functions of the angle about the center of area (R2adj = 0.79) showed in the cases that there was preservation of the cortical bone in the inferior region, with the proportional loss of cortical bone being greatest in the inferoanterior and superoposterior regions. It is concluded that loss of cortical, rather than cancellous, bone predominates in cases of femoral neck fracture. This loss occurs primarily along the inferoanterior to superoposterior axis. As this axis bears the greatest strain during a fall, it is hypothesized that specific thinning of the cortex in these regions leads to an exaggerated propensity to fracture in those so affected, above that resulting from an equivalent general decrease in bone mass.
Authors:
K L Bell; N Loveridge; J Power; N Garrahan; M Stanton; M Lunt; B F Meggitt; J Reeve
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research     Volume:  14     ISSN:  0884-0431     ISO Abbreviation:  J. Bone Miner. Res.     Publication Date:  1999 Jan 
Date Detail:
Created Date:  1999-02-22     Completed Date:  1999-02-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8610640     Medline TA:  J Bone Miner Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  111-9     Citation Subset:  IM    
Affiliation:
Bone Research Group (MRC), Department of Medicine, University of Cambridge, Cambridge, United Kingdom.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Biopsy
Bone Resorption / pathology*
Female
Femur Neck / pathology*
Hip Fractures / pathology*
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Reproducibility of Results

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Familial resemblance of bone mineral density (BMD) and calcaneal ultrasound attenuation: the BMD in ...
Next Document:  Site-specific effects of strength training on bone structure and geometry of ultradistal radius in p...