Determinants of femoral geometry and structure during adolescent growth

Our goal was to understand developmental determinants of femoral structure during growth and sexual maturation by relating femoral measurements to gender and developmental factors (age, pubertal stage, height, and body mass). The bone mineral content of the femur was measured by dual energy x‐ray absorptiometry in 101 healthy Caucasian adolescents and young adults, 9–26 years of age. After some simplifying assumptions had been made, cross‐sectional geometric properties of the femoral midshaft were estimated. Two geometry‐based structural indicators, the section modulus and whole bone strength index, were calculated to assess the structural characteristics of the femur. Femoral strength, as described by these structural indicators, increased dramatically from childhood through young adulthood. Regressions were performed between these femoral measurements and the developmental factors. Our data show that of age, pubertal stage, body mass, and height, body mass is the strongest predictor of femoral cross‐sectional properties, and the correlation of body mass with femoral cross‐sectional structure is independent of gender. A model including all four developmental factors and gender did not substantially increase the accuracy of predictions compared with the model with body mass alone. In light of previous research, we hypothesize that body mass is an indicator of in vivo loading and that this in vivo loading influences the cross‐sectional growth of the long bones.