Srpski arhiv za celokupno lekarstvo 2012 Volume 140, Issue 11-12, Pages: 738-745
https://doi.org/10.2298/SARH1212738D
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Morphological characteristics of the developing proximal femur: A biomechanical perspective
Đurić Marija (Medicinski fakultet, Institut za anatomiju, Laboratorija za antropologiju, Beograd)
Milovanović Petar (Medicinski fakultet, Institut za anatomiju, Laboratorija za antropologiju, Beograd)
Đonić Danijela (Medicinski fakultet, Institut za anatomiju, Laboratorija za antropologiju, Beograd)
Minić Arsa (Evropski univerzitet, Američki medicinski fakultet u Beogradu, Beograd)
Hahn Michael (Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany)
Introduction. In contrast to a plethora of studies on the proximal femur in
adults, its external and internal morphology in growing children has not been
sufficiently analyzed. Objective. We analyzed changes in external and
internal morphology of the proximal femur during growth and development to
interpret the links between them and concepts of the human femoral
biomechanics. Methods. We assessed external geometry, internal trabecular and
cortical arrangement, and bone mineral density (BMD) of the proximal femur in
29 children (age at death from 1 month to 14 years) from archaeological
context by using microscopic and radiographic methods. Results. The results
showed that both the femoral neck width and length increased with age, with
the femoral neck becoming more elongated, while the collo-diaphyseal angle
decreased. A strong relationship between age and adjusted areal BMD was
found, showing continuous increase during childhood. Parallel trabecular
pattern at birth changed to mature three distinct trabecular groups
(longitudinal – principal compressive, transversal – tensile and randomly
scattered) starting from the age of 8 months. In older children the superior
and inferior aspects of the femoral neck differently changed with growth,
with medial neck having thicker cortex and trabeculae. Conclusion. In the
light of bone adaptation principle, the observed changes in external and
internal morphology are governed by mechanical forces acting on the
developing femur. Our findings on the development of trabecular pattern and
cortical distribution are compatible with recent views on the femoral
biomechanics which point out the predominance of compressive stresses in the
femoral neck, adaptation to shear stresses, multiaxial loading perspective,
prevalence of muscle effects over body weight, and existence of adaptational
eccentricity.
Keywords: proximal femur, growth, bone adaptation, mechanical loading
Projekat Ministarstva nauke Republike Srbije, br. 45005