Shanghai Institute of Traumatology and Orthopaedics.
Osteoclastic resorption was studied with scanning electron microscope on cross sections of cortical bone of femoral neck collected from 7 aged women with an average age of 72.4 years, who underwent endoprosthetic replacement for intracapsular hip fracture. The cortical bone sections revealed enlargement of the Haversian canals. On the inner linings of the enlarged canals there were many oval-shaped resorption lacunae, reflecting osteoclastic resorption of the Haversian systems. The osteoclastic resorption with subsequent enlargement of the Haversian canals into round or oval cavities took place first over the inner portions of the cortical sections, thereby rendering these areas porotic (cancellization). These processes of the Haversian system and canals then gradually emerged over the central and eventually over the outer areas of the cortical bone, and the entire cortical bone became porotic. In the meanwhile, the inner porotic portion of the cortex turned into trabeculae (trabecularization) and became gradually resorbed, resulting in thinning of the medial cortex. Cortical cancellization, trabecularization and thinning so compromised the material strength of the femoral neck that fracture would ensue even with trivial injury.