Hip Fracture Risk Assessment Based on Different Failure Criteria Using QCT-Based Finite Element Modeling

Precise evaluation of hip fracture risk leads to reduce hip fracture occurrence in individuals and assist to check the effect of a treatment.A subject-specific QCT-based finite element model is introduced to evaluate hip fracture risk using the strain energy,von-Mises stress,and von-Mises strain criteria during the single-leg stance and the sideways fall configurations.Choosing a proper failure criterion in hip fracture risk assessment is very important.The aim of this study is to define hip fracture risk index using the strain energy,von Mises stress,and von Mises strain criteria and compare the calculated fracture risk indices using these criteria at the critical regions of the femur.It is found that based on these criteria,the hip fracture risk at the femoral neck and the intertrochanteric region is higher than other parts of the femur,probably due to the larger amount of cancellous bone in these regions.The study results also show that the strain energy criterion gives more reasonable assessment of hip fracture risk based on the bone failure mechanism and the von-Mises strain criterion is more conservative than two other criteria and leads to higher estimate of hip fracture risk indices.

Parametric Study of Hip Fracture Risk Using QCT-Based Finite Element Analysis

Various parameters such as age,height,weight,and body mass index(BMI)influence the hip fracture risk in the elderly which is the most common injury during the sideways fall.This paper presents a parametric study of hip fracture risk based on the gender,age,height,weight,and BMI of subjects using the subject-specific QCT-based finite element modelling and simulation of single-leg stance and sideways fall loadings.Hip fracture risk is estimated using the strain energy failure criterion as a combination of bone stresses and strains leading to more accurate and reasonable results based on the bone failure mechanism.Understanding the effects of various parameters on hip fracture risk can help to prescribe more accurate preventive and treatment plans for a community based on the gender,age,height,weight,and BMI of the population.Results of this study show an increase in hip fracture risk with the increase of age,body height,weight,and BMI in both women and men under the single-leg stance and the sideways fall configurations.

Experimental Validation of Subject-Specific Dynamics Model for Predicting Impact Force in Sideways Fall

Sideways fall has been identified as the most critical situation for the elderly to develop hip fractures. The impact force onto the greater trochanter is the key factor for predicting fracture risk. For the elderly, the impact force can only be determined by dynamics simulations, and the dynamics model must be first validated by experiments before it can be applied in clinic. In this study, subject-specific whole-body dynamics models constructed from dual energy X-ray absorptiometry (DXA) images of the subjects were validated by controlled and protected fall tests using young volunteers. The validation results suggested that subject-specific dynamics model is much more accurate in predicting impact force induced in sideways fall than conventional non-subject-specific dynamics model. Therefore, subject-specific dynamics model can be applied in clinic to improve the accuracy of assessing hip fracture risk.