The Journal of Bone and Joint Surgery, Vol 77, Issue 3 387-395, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Age-related reductions in the strength of the femur tested in a fall-loading configuration
AC Courtney, EF Wachtel, ER Myers and WC Hayes
Department of Orthopedic Surgery, Beth Israel Hospital, Boston, Massachusetts.
To assess age-related changes in femoral strength as a component in the
risk of fracture of the hip, we compared the loads at fracture of the
proximal aspects of femora from the cadavera of older and younger
individuals, as tested in a fall-loading configuration. To provide a basis
for non-invasive in vivo estimates of femoral strength, we also determined
the correlations between variables measured with dual-energy x-ray
absorptiometry and these loads. Femora from the cadavera of eight older
individuals (mean age, seventy-four years) and nine younger individuals
(mean age, thirty-three years) were scanned with a Hologic QDR-2000
densitometer to obtain densitometric and geometric information. The femora
were then tested mechanically in a loading configuration that simulated a
fall on the greater trochanter. The femora from the older group were half
as strong as those from the younger group (p < 0.001), and they absorbed
one-third as much energy (p < 0.001). The area bone-mineral density of
the femoral neck correlated strongly with the load at fracture (r2 = 0.92).
CLINICAL RELEVANCE: The prevalence of fracture of the hip increases
exponentially with age. 90 percent of those fractures are the result of a
simple fall from a standing height.(ABSTRACT TRUNCATED AT 250 WORDS)
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