We analyzed the bone microarchitecture of the subcapital and basicervical subregions of the femoral neck in men, to determine whether microarchitectural differences of cortical or trabecular bone can explain differential frequency of subcapital vs. basicervical fractures, especially in aged persons. The study sample encompassed twenty male proximal femora obtained during autopsy. They were divided in two age groups: young (< 40 years, n = 10) and aged (> 60 years, n = 10). Micro-computed tomography was used to evaluate cortical and trabecular microarchitecture of the subcapital and basicervical regions of the superolateral femoral neck–typical fracture initiation site. Basicervical region showed significantly thicker and less porous cortex than subcapital region (p = 0.02, p < 0.001, respectively), along with increased distance between cortical pores (p = 0.004) and smaller pore diameters (p = 0.069). Higher trabecular number (Tb.N: p = 0.042), lower trabecular thickness (Tb.Th: p < 0.001), and lower trabecular separation (p = 0.003) were also hallmarks of the basicervical compared to subcapital region, although BV/TV was similar in both regions (p = 0.133). Age-related deterioration was mostly visible in trabecular bone (for BV/TV, Tb.Th, Tb.N and fractal dimension: p = 0.026, p = 0.049, p = 0.059, p = 0.009, respectively). Moreover, there were tendencies to age-specific patterns of trabecular separation (more pronounced inter-site differences in aged) and cortical thickness (more pronounced inter-site differences in young). Trabecular microarchitecture corresponded to cortical characteristics of each region. Our study revealed the microarchitectural basis for higher incidence of subcapital than basicervical fractures of the femoral neck. This is essential for better understanding of the fracture risk, as well as for future strategies to prevent hip fractures and their complications.

我们分析了男性股骨颈下和基本神经节区域的骨微结构，以确定皮质或小梁骨的微结构差异是否可以解释尤其是在老年人中，颈下和基本神经骨折的频率差异。研究样本包括在尸检过程中获得的二十个男性近端股骨。他们分为两个年龄段：年轻（<40岁，n  = 10）和年龄（> 60岁，n  = 10）。显微计算机断层扫描用于评估股外侧颈-典型骨折起始部位的资本下和基本神经区域的皮质和小梁微结构。与首都下区相比，基本神经区的皮层明显厚，多孔少（p = 0.02，p  <0.001，分别），以及皮质孔之间的距离增加（p  = 0.004）和较小的孔径（p  = 0.069）。更高小梁骨数量（Tb.N：p  = 0.042），降低骨小梁厚度（Tb.Th：p  <0.001），并降低骨小梁间距（p  = 0.003）也相比于头下区域basicervical的标志，虽然BV / TV在两个地区相似（p  = 0.133）。与年龄相关的退化大部分在小梁骨中可见（对于BV / TV，Tb.Th，Tb.N和分形维数：p  = 0.026，p  = 0.049，p  = 0.059，p 分别为0.009）。而且，存在特定年龄的骨小梁分离模式（老年时更明显的部位间差异）和皮层厚度（年轻时更明显的部位间差异）。小梁微结构对应于每个区域的皮质特征。我们的研究揭示了股骨颈下股骨骨折的发生率较高的微结构基础。这对于更好地了解骨折风险以及未来预防髋部骨折及其并发症的策略至关重要。