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Three-Dimensional Microstructural Basis for Differential Occurrence of Subcapital versus Basicervical Hip Fractures
Aleksandar Cirovic1, Ana Cirovic1, Danijela Djonic1
1Laboratory for Anthropology and Skeletal Biology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Dr Subotica 4/2, Belgrade, 11000, Serbia.
Calcified Tissue International
|July 1, 2020
Summary
Differences in bone microarchitecture between subcapital and basicervical femoral neck regions explain higher subcapital fracture rates. Aged men show more bone deterioration, particularly in trabecular bone, impacting fracture risk.
Area of Science:
- Orthopedics
- Bone Biology
- Gerontology
Background:
- Subcapital and basicervical femoral neck fractures exhibit differential frequencies, particularly in aged individuals.
- Understanding the underlying bone microarchitecture is crucial for explaining these fracture patterns and informing prevention strategies.
Purpose of the Study:
- To investigate microarchitectural differences in cortical and trabecular bone between the subcapital and basicervical regions of the male femoral neck.
- To determine if these differences contribute to the varying incidence of subcapital versus basicervical fractures, especially in older populations.
Main Methods:
- Analysis of proximal femora from twenty male donors, divided into young (<40 years) and aged (>60 years) groups.
- Micro-computed tomography (micro-CT) was employed to assess cortical and trabecular bone microarchitecture in both subcapital and basicervical regions.
- Key microarchitectural parameters including bone volume fraction, trabecular number, thickness, separation, pore size, and cortical thickness were quantified.
Main Results:
- The basicervical region demonstrated a significantly thicker, less porous cortex with smaller pore diameters compared to the subcapital region.
- Trabecular bone in the basicervical region exhibited higher bone number, lower thickness, and lower separation than in the subcapital region.
- Age-related deterioration was predominantly observed in trabecular bone characteristics, with tendencies towards age-specific patterns in inter-site differences for both cortical and trabecular parameters.
Conclusions:
- Distinct microarchitectural properties of the subcapital and basicervical femoral neck regions provide a basis for the observed higher incidence of subcapital fractures.
- Age significantly impacts bone microarchitecture, particularly trabecular bone, further influencing fracture risk in older men.
- These findings are essential for improving the understanding of femoral neck fracture risk and developing targeted prevention strategies.
