Geometry of the proximal femur during growth and its contribution to childhood fractures in healthy children
Authors' conclusion
These findings provide the foundation for evaluating hip geometry as an indicator of bone strength in children.
Study context
- Population
- Healthy U.S. children, ages 5–23y, Bone Mineral Density in Childhood Study
- Participants
- 2,014 children
- Outcome
- HSA measures and childhood fracture risk
Methodological detailsmulti-center, up to 7 annual visits
- Multi-center
- Up to 7 annual visits
Main finding
As reported in the abstract
Narrow neck buckling ratio Z-score, HR for fracture
1.16
95% CI 1.02, 1.31
Hip axis length Z-score, HR for fracture
1.20
95% CI 1.00, 1.44
Adjusted for BMD Z-score, BMIZ, Tanner stage, sex: narrow neck cross-sectional area, cross-sectional moment of inertia, section modulus and bone width, and femoral shaft cross-sectional area and section modulus Z-scores positively associated with fractures; e.g., section modulus Z-score: increased fracture risk
44%
Observational data: associations, not effects.
Further findings
Precision of hip structural analysis (HSA) measures
- Femoral shaft measures, CV
- 1.1 to 3.7%
- Narrow neck measures, CV
- 2.2 to 7.4%
- Buckling ratio (both sites) least precise
Tracking of HSA Z-scores over one year
- HSA Z-score tracking
- 0.77 to 0.94
Age and sex
- Age-related trends and sex differences in hip geometry
Original publication
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