title: Age- and sex-related changes of humeral head microarchitecture: histomorphometric analysis of 60 human specimens.
abstract: Fractures of the humeral head are frequent and will further increase due to demographic changes. Prior to operative fracture treatment, the regional differences of bone quality, especially of elderly people, have to be carefully considered to assure stable implant fixation. However, conclusive data concerning the variation of histomorphometric parameters are still lacking. Consequently, the purpose of this study was to analyze the age- and sex-related changes in bone microarchitecture. For that reason, 60 proximal humeri were harvested from patients at autopsy. Twelve regions of interest (ROI) were defined for each centered coronar humeral head slice and the specimens were subjected to radiographic, histological, and histomorphometric analyses. We could demonstrate that in contrast to men, women over 60 years of age had a significant age-related decrease in bone mass. The most prominent decrease was observed in the region of the greater tuberosity, which represents an osteoporotic fracture site. The most superior and medially located part of the centered coronar humeral head slice showed, independent from age and sex, the highest bone mass and can therefore be considered as the best location for subchondral screw placement. Taken together, our study revealed distinct sex-related changes of the humeral head bone microarchitecture with aging, which should be considered in implant positioning.
authors.affiliation: Center for Biomechanics and Skeletal Biology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. amling@uke.uni-hamburg.de
authors.forename: Florian
authors.initials: F
authors.lastname: Barvencik
authors.forename: Matthias
authors.initials: M
authors.lastname: Gebauer
authors.forename: Frank Timo
authors.initials: FT
authors.lastname: Beil
authors.forename: Eik
authors.initials: E
authors.lastname: Vettorazzi
authors.forename: Marcus
authors.initials: M
authors.lastname: Mumme
authors.forename: Martin
authors.initials: M
authors.lastname: Rupprecht
authors.forename: Pia
authors.initials: P
authors.lastname: Pogoda
authors.forename: Karl
authors.initials: K
authors.lastname: Wegscheider
authors.forename: Johannes M
authors.initials: JM
authors.lastname: Rueger
authors.forename: Klaus
authors.initials: K
authors.lastname: Pueschel
authors.forename: Michael
authors.initials: M
authors.lastname: Amling
mesh_terms: D000328:Adult; D000367:Age Factors; D015519:Bone Density; D002102:Cadaver; D005260:Female; D006801:Humans; D006811:Humerus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012737:Sex Factors; D055815:Young Adult