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Population-based, three-dimensional analysis of age- and sex-related femur shaft geometry differences

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Abstract

Summary

This study deals with differences of femoral geometric focus on the bowing and width. Analysis using three-dimensional skeletonization showed increase of femoral bowing and femur width over life (more in women), and widening of the medullary canal only in women after 50 years old, not in men.

Introduction

The changes in femur geometry that occur with aging and lead to fragility or insufficiency fracture remain unclear. The role of the lower limb geometry, including the femur and femoral bowing, has become a point of discussion, especially in atypical femur fracture. This study aimed to analyze femur shaft geometry using three-dimensional skeletonization.

Methods

We acquired computed tomography images of both femurs obtained. A total of 1400 age- and sex-stratified participants were enrolled and were divided into subgroups according to age (by decade) and sex. The computed tomography images were used to produce 3-dimensional samplings of anatomical elements of the human femur using reconstruction and parametrization from these datasets. The process of skeletonization was conducted to obtain compact representation of the femur. With the skeletonization, we were able to compare all parameters according to age and sex.

Results

The femur length was 424.4 ± 28.6 mm and was longer in men (P < 0.001). The minimum diameter of the medullary canal was 8.9 ± 2.0 mm. The radius of curvature (ROC) was 906.9 ± 193.3 mm. Men had a larger femur length, femur outer diameter, and the narrowest medullary diameter (P < 0.001, respectively). Women had significantly smaller ROC (P < 0.001). ROC decreased by 19.4% in men and 23.6% in women between the ages of 20 to 89 years. Femur width increased over life by 11.4% in men and 24.5% in women. Between the ages of 50 and 89 years, the medullary canal appears to have increased by 32.7% in women.

Conclusion

This geometry analysis demonstrated that femoral bowing and femoral width increased related to aging, and that the medullary canal widened after the age of 50 years in women. This cross-sectional study revealed important age- and sex-related differences in femur shaft geometry that occur with aging.

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Data availability

We did not add supplement data and materials in submission but are available in request to the corresponding author if it is necessary for review Code availability Not applicable Authors’ contributions.

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Funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2018R1D1A1B07050224).

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Authors and Affiliations

  1. University of Ulsan College of Medicine, Seoul, Republic of Korea

    I. J. Jung

  2. Department of Orthopaedics, Asan Medical Center, Seoul, Republic of Korea

    E. J. Choi & J. W. Kim

  3. Division of Computer Engineering, Dongseo University, Busan, Republic of Korea

    B. G. Lee

  4. Department of Orthopedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    J. W. Kim

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  1. I. J. Jung
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Correspondence to J. W. Kim.

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Conflict of interest

Ik Jae Jung, Eun Jung Choi, Byung Gook Lee, and Ji Wan Kim declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee.

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Jung, I.J., Choi, E.J., Lee, B.G. et al. Population-based, three-dimensional analysis of age- and sex-related femur shaft geometry differences. Osteoporos Int 32, 1631–1638 (2021). https://doi.org/10.1007/s00198-021-05841-6

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  • DOI: https://doi.org/10.1007/s00198-021-05841-6

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