Med Biol Eng Comput - Does femoral strain distribution coincide with the occurrence of cervical versus trochanteric hip fractures? An experimental finite element study.

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Resumo

The objective of this experimental finite element (FE) study is to test the hypothesis that strain distributions coincide with the occurrence of cervical versus trochanteric hip fractures during loading conditions simulating a sideways fall, and that the cervical versus trochanteric principal strain ratio predicts different fracture patterns. Cadaver femora (female, 83 +/- 9 years) were CT scanned and mechanically tested simulating a fall. Thirteen cervical and 13 trochanteric fracture cases were selected for FE analysis. Principal strain distributions were analysed, and strain ratio epsilon(C)/epsilon(T) for strain patterns over the cervical and trochanteric regions was computed. The ratio epsilon(C)/epsilon(T) in the femora with cervical fractures (mean +/- SD 1.103 +/- 0.127) differed from that in trochanteric fractures (0.925 +/- 0.137) (p = 0.001). The significant difference in the strain ratio between fracture types remained after accounting for femoral neck and trochanteric BMD (p = 0.014), showing that it is independent of BMD. Area under the ROC curve was 0.858 in the discrimination of fracture types. The model predicted the experimental fracture type correctly in 22 of 26 cases. The cervical versus trochanteric region principal strain ratio differed significantly between femora with experimental cervical versus trochanteric fractures, and 85% agreement was achieved for the occurrence of hip fracture types using a simple FE model.

Resumo Limpo

object experiment finit element fe studi test hypothesi strain distribut coincid occurr cervic versus trochanter hip fractur load condit simul sideway fall cervic versus trochanter princip strain ratio predict differ fractur pattern cadav femora femal year ct scan mechan test simul fall thirteen cervic trochanter fractur case select fe analysi princip strain distribut analys strain ratio epsiloncepsilont strain pattern cervic trochanter region comput ratio epsiloncepsilont femora cervic fractur mean sd differ trochanter fractur p signific differ strain ratio fractur type remain account femor neck trochanter bmd p show independ bmd area roc curv discrimin fractur type model predict experiment fractur type correct case cervic versus trochanter region princip strain ratio differ signific femora experiment cervic versus trochanter fractur agreement achiev occurr hip fractur type use simpl fe model

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