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Sass JO, Saemann M, Kebbach M, Soodmand E, Wree A, Bader R, Kluess D. The Morphology of the Femur Influences the Fracture Risk during Stumbling and Falls on the Hip-A Computational Biomechanical Study. Life (Basel) 2024; 14:841. [PMID: 39063595 PMCID: PMC11277570 DOI: 10.3390/life14070841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024] Open
Abstract
Proximal femur fracture risk depends on subject-specific factors such as bone mineral density and morphological parameters. Here, we aim to analyze the dependency of the femoral strength on sixteen morphological parameters. Therefore, finite-element analyses of 20 human femurs during stumbling and lateral falls on the hip were conducted. Pearson correlation coefficients were calculated and morphological parameters with significant correlations were examined in principal component analysis and linear regression analysis. The dependency of the fracture strength on morphological parameters was more pronounced during lateral falls on the hip compared to stumbling. Significant correlations were observed between the neck shaft angle (r = -0.474), neck diameter (r = 0.507), the true distance between the femoral head center and femoral shaft axis (r = 0.459), and its projected distance on the frontal plane (r = 0.511), greater trochanter height (r = 0.497), and distance between the femoral head center and a plane parallel to the frontal plane containing the projection of the femoral head center to the femoral neck axis (r = 0.669). Principal component analysis was strongly weighted by parameters defining the lever arm during a lateral fall as well as the loaded cross-section in the femoral neck.
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Affiliation(s)
- Jan-Oliver Sass
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopaedics, Rostock University Medical Center, Doberaner Str. 142, 18057 Rostock, Germany
| | - Michael Saemann
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopaedics, Rostock University Medical Center, Doberaner Str. 142, 18057 Rostock, Germany
| | - Maeruan Kebbach
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopaedics, Rostock University Medical Center, Doberaner Str. 142, 18057 Rostock, Germany
| | - Ehsan Soodmand
- Julius Wolff Institut, Center for Musculoskeletal Biomechanics and Regeneration, Berlin Institute of Health—Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany;
| | - Andreas Wree
- Institute for Anatomy, Rostock University Medical Center, Gertrudenstraße 9, 18057 Rostock, Germany
| | - Rainer Bader
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopaedics, Rostock University Medical Center, Doberaner Str. 142, 18057 Rostock, Germany
| | - Daniel Kluess
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopaedics, Rostock University Medical Center, Doberaner Str. 142, 18057 Rostock, Germany
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Awal R, Faisal T. QCT-based 3D finite element modeling to assess patient-specific hip fracture risk and risk factors. J Mech Behav Biomed Mater 2024; 150:106299. [PMID: 38088011 DOI: 10.1016/j.jmbbm.2023.106299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/12/2023] [Accepted: 12/02/2023] [Indexed: 01/09/2024]
Abstract
Early assessment of hip fracture risk may play a critical role in designing preventive mechanisms to reduce the occurrence of hip fracture in geriatric people. The loading direction, clinical, and morphological variables play a vital role in hip fracture. Analyzing the effects of these variables helps predict fractures risk more accurately; thereby suggesting the critical variable that needs to be considered. Hence, this work considered the fall postures by varying the loading direction on the coronal plane (α) and on the transverse plane (β) along with the clinical variables-age, sex, weight, and bone mineral density, and morphological variables-femoral neck axis length, femoral neck width, femoral neck angle, and true moment arm. The strain distribution obtained via finite element analysis (FEA) shows that the angle of adduction (α) during a fall increases the risk of fracture at the greater trochanter and femoral neck, whereas with an increased angle of rotation (β) during the fall, the FRI increases by ∼1.35 folds. The statistical analysis of clinical, morphological, and loading variables (αandβ) delineates that the consideration of only one variable is not enough to realistically predict the possibility of fracture as the correlation between individual variables and FRI is less than 0.1, even though they are shown to be significant (p<0.01). On the contrary, the correlation (R2=0.48) increases as all variables are considered, suggesting the need for considering different variables fork predicting FRI. However, the effect of each variable is different. While loading, clinical, and morphological variables are considered together, the loading direction on transverse plane (β) has high significance, and the anatomical variabilities have no significance.
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Affiliation(s)
- Rabina Awal
- Department of Mechanical Engineering, University of Louisiana at Lafayette, Louisiana, USA
| | - Tanvir Faisal
- Department of Mechanical Engineering, University of Louisiana at Lafayette, Louisiana, USA.
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Cui Y, Xiang D, Shu L, Duan Z, Liao Z, Wang S, Liu W. Incremental Element Deletion-Based Finite Element Analysis of the Effects of Impact Speeds, Fall Postures, and Cortical Thicknesses on Femur Fracture. MATERIALS 2022; 15:ma15082878. [PMID: 35454571 PMCID: PMC9025544 DOI: 10.3390/ma15082878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 02/05/2023]
Abstract
The proximal femur’s numerical simulation could give an effective method for predicting the risk of femoral fracture. However, the majority of existing numerical simulations is static, which does not correctly capture the dynamic properties of bone fractures. On the basis of femoral fracture analysis, a dynamic simulation using incremental element deletion (IED)-based finite element analysis (FEA) was developed and compared to XFEM in this study. Mechanical tests were also used to assess it. Different impact speeds, fall postures, and cortical thicknesses were also studied for their implications on fracture types and mechanical responses. The time it took for the crack to shatter was shorter when the speed was higher, and the crack line slid down significantly. The fracture load fell by 27.37% when the angle was altered from 15° to 135°, indicating that falling forward was less likely to cause proximal femoral fracture than falling backward. Furthermore, the model with scant cortical bone was susceptible to fracture. This study established a theoretical foundation and mechanism for forecasting the risk of proximal femoral fracture in the elderly.
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Affiliation(s)
- Yangyang Cui
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China; (Y.C.); (Z.D.)
- School of Mechanical Engineering and Automation, Northeastern University, Shenyang 110057, China
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China;
- Key Laboratory of Biomedical Materials and Implant Devices, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
| | - Dingding Xiang
- School of Mechanical Engineering and Automation, Northeastern University, Shenyang 110057, China
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China;
- Key Laboratory of Biomedical Materials and Implant Devices, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
- Correspondence: (D.X.); (S.W.); (W.L.)
| | - Liming Shu
- Department of Mechanical Engineering, School of Engineering, The University of Tokyo, Tokyo 1138656, Japan;
| | - Zhili Duan
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China; (Y.C.); (Z.D.)
| | - Zhenhua Liao
- Key Laboratory of Biomedical Materials and Implant Devices, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
| | - Song Wang
- Key Laboratory of Biomedical Materials and Implant Devices, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
- Correspondence: (D.X.); (S.W.); (W.L.)
| | - Weiqiang Liu
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China; (Y.C.); (Z.D.)
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China;
- Key Laboratory of Biomedical Materials and Implant Devices, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, China
- Correspondence: (D.X.); (S.W.); (W.L.)
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