Prediction of femoral fracture load using automated finite element modeling
Prediction of femoral fracture load using automated finite element modeling
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DOI：
10.1016/s0021-9290(97)00123-1
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发表时间：
1998-02-01
影响因子：
2.4
通讯作者：
Skinner, HB
中科院分区：
文献类型：
--
作者：
Keyak, JH;Rossi, SA;Skinner, HB
髋部骨折是老年人发病和死亡的一个重要原因。目前评估患者髋部骨折风险的方法包括局部骨密度估计（骨密度测量法），但由于无法考虑股骨复杂的结构特征而存在局限性。为了改进用于评估髋部骨折风险的临床和研究工具，本研究探讨了基于计算机断层扫描（CT）自动生成的有限元（FE）模型是否可用于体外估计股骨骨折负荷。在两种加载条件下对18对股骨进行了检查——一种类似于步态站立阶段的加载，另一种模拟跌倒的冲击。然后对股骨进行力学测试直至破坏，并对测量的骨折负荷和有限元预测的骨折负荷进行回归分析。为了进行比较，还检查了骨密度测量指标。在测量的骨折负荷和有限元预测的骨折负荷之间发现了显著的相关性（站立时r = 0.87；跌倒时r = 0.95；站立和跌倒数据合并时r = 0.97），在测量的骨折负荷和骨密度测量数据之间也发现了显著相关性（站立时r = 0.78；跌倒时r = 0.91）。这些结果表明，这种仍处于早期发展阶段的复杂技术可以达到与骨密度测量法相当的精度，并且能够在95%的置信度下将股骨骨折负荷预测在 - 40%到 + 60%的范围内。因此，目前这种需要额外的X射线暴露以及CT扫描费用的方法在临床上的应用是不合理的。即便如此，这种CT/FE技术的潜在优势支持在该领域进行进一步的研究。（C）1998年爱思唯尔科学有限公司。保留所有权利。
Hip fracture is an important cause of morbidity and mortality among the elderly. Current methods of assessing a patient's risk of hip fracture involve local estimates of bone density (densitometry), and are limited by their inability to account for the complex structural features of the femur. In an effort to improve clinical and research tools for assessing hip fracture risk, this study investigated whether automatically generated, computed tomographic (CT) scan-based finite element (FE) models can be used to estimate femoral fracture load in vitro. Eighteen pairs of femora were examined under two loading conditions - one similar to loading during the stance phase of gait, and one simulating impact from a fall. The femora were then mechanically tested to failure and regression analyses between measured fracture load and FE-predicted fracture load were performed. For comparison, densitometry measures were also examined. Significant relationships were found between measured fracture load and FE-predicted fracture load (r = 0.87, stance; r = 0.95, fall; r = 0.97, stance and fall data pooled) and between measured fracture load and densitometry data (r = 0.78, stance; r = 0.91, fall). These results indicate that this sophisticated technique, which is still early in its development, can achieve precision comparable to that of densitometry and can predict femoral fracture load to within -40% to + 60% with 95% confidence. Therefore, clinical use of this approach, which would require additional X-ray exposure and expenditure for a CT scan, is not justified at this point. Even so, the potential advantages of this CT/FE technique support further research in this area. (C) 1998 Elsevier Science Ltd. All rights reserved.