Bone stiffness in children: part I. In vivo assessment of the stiffness of femur and tibia in children.

Although there are many publications concerning the mechanical behavior of adult bone, there are few data about mechanical properties of children's bone. In vivo bone stiffness measurement with Orthometer device has been validated and extensively used in adults to assess bone healing after fracture or lengthening. We hypothesized that in vivo stiffness measurement with Orthometer was applicable in children and was correlated with age, height, body weight, and corpulence index. The purpose was to establish baseline stiffness values for femur and tibia in growing children.Sixteen bone measurements (7 femurs and 9 tibias) were obtained during application of an external fixator for leg lengthening in 11 children aged between 5.5 and 16.7 years. A 3-point bending test with an Orthometer was carried out on the intact bone (before osteotomy) under general anesthesia. The anteroposterior stiffness measurement was successful in all children of the series, aged from 5.5 to 16.7 years. A wide variation of femoral and tibial bone stiffness values were observed. The use of a unique value as in adults as the end point of bending stiffness during bone healing process is not possible for children. The anteroposterior bone stiffness was found to have linear correlation with children's height and body weight, but not with age and corpulence indexes. The original data obtained by this study will give a stiffness reference for height and weight and could be useful as reference values for monitoring of healing process after fracture or limb lengthening.