The effect of impact direction on the structural capacity of the proximal femur during falls.
The effect of impact direction on the structural capacity of the proximal femur during falls.
复制标题
跌倒时冲击方向对股骨近端结构能力的影响。
DOI：
10.1002/jbmr.5650110311
复制
发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Hayes,WC
中科院分区：
文献类型：
--
作者：
Ford,CM;Keaveny,TM;Hayes,WC
与任何结构一样，股骨近端的结构能力取决于施加的载荷，并且这些载荷可以作为跌倒期间冲击方向的函数而变化。然而，尽管它在髋部骨折风险评估中具有潜在的重要性，但撞击方向的相对重要性尚不清楚。为了研究撞击方向在髋部骨折中的作用，我们建立了股骨近端的详细有限元模型。我们分析了四种负载配置，这些配置代表了大转子上一系列可能的福尔斯跌倒。我们的研究结果表明，施加力的作用线与股骨颈轴线之间的角度从0°（代表直接外侧冲击）到45°（代表后外侧冲击）的变化使结构能力降低了26%。这种随撞击方向变化的股骨弱化与2-3年年龄相关骨丢失相关的弱化相当。我们的研究结果阐明了独立的贡献跌倒力学髋部骨折的风险，确定一个方面的下降（影响的方向），这是一个重要的决定因素下降的严重程度。这些结果也可以被纳入一个完善的临床方法，用于评估髋部骨折的风险，解释跌倒严重程度和骨脆性之间复杂的相互作用。
As with any structure, the structural capacity of the proximal femur depends on the applied loads and these can vary as a function of impact direction during a fall. However, despite its potential importance in hip fracture risk assessment, the relative importance of impact direction is unknown. To investigate the role of impact direction in hip fracture, we developed a detailed finite element model of the proximal femur. We analyzed four loading configurations that represent a range of possible falls on the greater trochanter. Our results indicate that a change in the angle between the line of action of the applied force and the axis of the femoral neck from 0° (representing a direct lateral impact) to 45° (representing a posterolateral impact) reduced structural capacity by 26%. This weakening of the femur with changes in impact direction is comparable to the weakening associated with 2–3 decades of age‐related bone loss. Our result elucidates the independent contribution of fall mechanics to hip fracture risk by identifying an aspect of the fall (the direction of impact) that is an important determinant of fall severity. The results can also be incorporated into a refined clinical method for assessment of hip fracture risk that accounts for the complex interactions between fall severity and bone fragility.