Background: The femoral neck is a common osteoporotic fracture site. In this study we investigate changes in mean periosteal thickness with age, sex, side and circumference along the femoral neck. We hypothesised that: periosteal thickness declines with age, that the periosteum is thicker in males, is thickest inferiorly around the neck, and becomes thicker distally along the neck.
Methods and findings: Sixteen femoral necks from 9 cadavers (mean age 82.78, 5 female, 4 male) were sectioned, decalcified and stained. Periosteal thickness in 4 quadrants around the circumference, and along its length, was measured. The difference in mean periosteal coverage between sexes was found to be insignificant (p=0.2857), and did not appear to decline with age (p=0.7760). No significant changes in periosteal thickness were seen along the length of the neck (p=0.9594). There was, however, a significant difference in coverage around the circumference of the femoral neck (p<0.0001).
Conclusions: The differences in periosteal coverage around the circumference of the femoral neck reported here are open to several theories. There may be potential for pharmacological intervention, gene-related therapy or periosteal transplant to target specifically vulnerable sites.
Manzar H, Antonios TT and Adds PJ
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