Skeletal growth: A major determinant of bone's structural diversity in women and men

Skeletal fragility in advanced age has its antecedence in growth because the variance in bone traits achieved during growth is an order of magnitude greater than rates of loss during aging. Factors modifying skeletal morphology such as exercise and nutrition are likely to be best during growth. At puberty, appendicular growth decelerates while axial growth accelerates. Sex differences in bone length, width, mass, and strength emerge largely during puberty. In late puberty, there is slowing of longitudinal bone growth. The effects of illness during growth depend on the maturational stage at the time of disease exposure, not just the “severity” of the illness. In particular, growth of the distal radius is more rapid at the distal metaphysis, and at this site the longitudinal growth outpaces bone formation upon the surfaces of trabeculae emerging from the growth plate, delaying their coalescence.