Bone size and mechanics at the femoral diaphysis across age and sex

The reasons for the increase in fracture rates with age are not fully understood. It is known that there is a decrease in bone mass with a presumed loss of strength. This decrease may possibly be compensated for by changes in cross-sectional geometry. Previous studies, which have been limited by lack of information on subjects’ heights and weights, were not able to resolve this issue. In this study, measurements of cross-sectional geometry (area and second moments of area) from 107 specimens of human femoral diaphysis from subjects aged 21–92 years were analysed. Mathematical models of the variation in bone geometry with age were developed. These models included the effects of sex, height and weight. Values of parameters from these models were then used in a biomechanical analysis of the static stresses at the mid-shaft of the femur. Results indicate that although there was a reduction in cortical area in old age, bone tissue was redistributed so that neither bending stresses in the coronal plane nor torsional stresses were higher in old age than in young adulthood. An additional finding was that at any age women had smaller bones, less cortical bone area and higher bone stresses than men. This finding may have some bearing on the higher fracture incidence seen in older women.