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Femur morphology in healthy infants and young children
Gina Bertocci1, Nathan P Brown1, Angela Thompson2
1Department of Bioengineering, J.B. Speed School of Engineering, University of Louisville, Louisville, Kentucky, USA.
Insights
Femur morphology in children aged 0-3 years shows significant growth. Key measures like femur length and bone strength increase with age and weight, crucial for understanding fracture risk during early mobility.
Area of Science:
- Orthopedics
- Pediatric Radiology
- Biomechanical Engineering
Background:
- Understanding pediatric bone development is essential for assessing skeletal health and injury risk.
- Femur morphology changes significantly during infancy and early childhood, impacting biomechanical properties.
- Previous studies have not comprehensively characterized femur morphology and structural properties in healthy children aged 0-3 years.
Purpose of the Study:
- To characterize femur morphology and structural properties in healthy infants and young children (0-3 years).
- To evaluate the relationship between femur measures and subject age and body mass.
- To provide normative data for pediatric femur development.
Main Methods:
- Retrospective analysis of 169 anterior-posterior (AP) femur radiographs from 99 healthy children (0-3 years).
- Measurement of femur morphological parameters (length, diaphysis diameter, growth plate width, radius of curvature) and structural properties.
- Statistical analysis to compare measures based on age and mass, and evaluate relationships.
Main Results:
- Femur length, trochanter width, minimum diaphysis diameter, and growth plate width significantly increased with both age and weight (p < 0.001).
- Structural properties, including cross-sectional area, polar moment of inertia, moment of inertia, and polar modulus, also showed significant increases with age and weight (p < 0.001).
- Medullary canal diameter at the minimum diaphysis increased with age and weight (p < 0.001).
Conclusions:
- Femur morphology and structural properties undergo substantial development in healthy children from 0-3 years.
- These developmental changes correlate strongly with increasing age and body mass.
- The findings are critical for understanding bone strength and fracture risk during the transition to independent walking in young children.
Abstract:
The objective of this study was to characterize femur morphology in healthy infants and young children. Anterior-posterior (AP) radiographs of the femur from children age 0-3 years with no history of bone disease were obtained from two children's hospitals and one medical examiner's office. Femur morphological measures (bone length, minimum diaphysis diameter, growth plate width, and femur radius of curvature) and sectional structural measures were determined. Measures were described and compared based on subject age and mass. Relationships between measures and age and mass were evaluated. The 169 AP femur radiographs were obtained from 99 children (59.6% males, median age = 12.0 months, IQR = 0-27.5 months, median body weight = 10.0 kg, IQR = 4.4-15.6 kg). Femur length (rs = 0.97, p < 0.001; rs = 0.89, p < 0.001), trochanter width (rs = 0.86, p < 0.001; rs = 0.85, p < 0.001), minimum diaphysis diameter (rs = 0.91, p < 0.001; rs = 0.87, p < 0.001), and growth plate width (rs = 0.91, p < 0.001; rs = 0.84, p < 0.001) increased with age and weight, respectively. Cross-sectional area (rs = 0.87; rs = 0.86; p < 0.01), polar moment of inertia (rs = 0.91; rs = 0.87; p < 0.001), moment of inertia (rs = 0.91; rs = 0.87; p < 0.001), polar modulus (rs = 0.91; rs = 0.87; p < 0.001) and medullary canal diameter (rs = 0.83, p < 0.001; rs = 0.73, p < 0.001) at the minimum diaphysis also increased with age and weight, respectively. Changes during rapid bone growth are important to understanding fracture risk in infants and young children as they transition to independent walking. Femur length, trochanter width, minimum diaphysis diameter and growth plate width increased with age and weight. Structural properties associated with fracture resistance also increased with age and weight.
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