Wolff: straight not curved

Abstract

It was 140 years ago that George von Meyer presented his anatomical diagrams of human bones to a meeting in Zurich. There he was told by Prof. Karl Culmann that the trabecular lines shown within the diagram of the upper femur closely resembled those lines of force which Culmann had determined with Graphic Statics to be passing through a curved, loaded Fairbairn crane. This drew the attention of Julius Wolff, who used this as the basis for his 'Trajectorial theory' which was widely accepted and, to date, has been the underlying basis for all biomechanical investigations of this region. Following Wolff and Culmann, the upper femur is considered to be a curved structure and is investigated as such. Unfortunately, this concept is wrong. The upper femur is not curved but is angular. It is formed by the junction of two straight bones, the femoral neck and the femoral shaft, as may be simply seen as the neck/shaft angle constructed on the antero-posterior radiograph of any normal femur. The internal trabecular bone forms only part of the load bearing structure of the femoral neck. The configuration of this trabecular substance in this region suggests that it is related specifically to the force present during flexion and extension movements of the hip joint. This being so, combined with the delayed timing of the appearance of the trabecular columns, it must be questioned as to whether the remodelling of the upper femur is in response to one or to two distinct forces.

Keywords: Bone modeling; Compression force; Femoral cortex; Femoral neck; Femoral trabeculae; Femur; Hip Anatomy; Hip biomechanics; Hip forces; Neck/shaft angle; Neck/shaft junction; Trajectorial theory; Upper femur; Wolff’s law.