ArticleFrontiers in endocrinology2026
CT-based age-related trabecular redistribution in the proximal femur and its association with fracture patterns in elderly individuals with and without diabetes.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Proximal femoral fractures are the most common fall-related fractures in the elderly. In our clinical work, we observed a phenomenon of trabecular redistribution in the proximal femur of older individuals. To investigate the distribution of bone trabeculae (compression and tension trabeculae) in the proximal femur, their changes with age, and their impact on fracture risk, we retrospectively analyzed hip computed tomography (CT) images and measured CT values in six different regions of the proximal femur: the primary compression trabecula, overlapping area, primary tension trabecula, secondary compression trabecula, the greater trochanter and lateral of primary tension trabecula. With increasing age, the CT values in six regions decreased (p<0.01). The ratio of the primary compression trabecular area to the overlapping area remained relatively stable (F = 1.84, p=0.12), whereas the ratio of the primary tension trabecular area to the overlapping area decreased (F = 9.67, p<0.01). Elderly patients with proximal femoral fractures exhibited significant trabecular redistribution. Notably, compared to non-diabetic elderly patients with proximal femoral fractures, those with diabetes and femoral fractures showed a marked decrease in the ratio of the primary compression trabecular area to the overlapping area relative to normal controls (d=-0.40, p<0.05). These findings may improve understanding of altered fracture susceptibility in elderly diabetic patients. In conclusion, although bone density in the proximal femur generally declines with age, trabecular redistribution occurs, characterized by a relative reduction in tension trabeculae and a relatively stable ratio of compression trabeculae. However, in elderly diabetic patients with fractures, the compression trabeculae fail to maintain this stable ratio, which may reflect altered trabecular adaptation associated with fracture susceptibility.
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