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Does femoral strain distribution coincide with the occurrence of cervical versus trochanteric hip fractures? An experimental finite element study

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Abstract

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 εC/εT for strain patterns over the cervical and trochanteric regions was computed. The ratio εC/εT 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.

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Acknowledgments

The authors acknowledge Dr. Miika Nieminen for his valuable comments on the manuscript. The study was supported by the Finnish Funding Agency for Technology and Innovation (grant nr. 40463/05), the International Graduate School of Biomedical Engineering, the Academy of Finland, as well as a grant of the Deutsche Forschungsgemeinschaft (DFG LO 730/3-1), and the Finnish Cultural Foundation, North Ostrobothnia Regional fund.

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Authors and Affiliations

  1. Department of Medical Technology, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland

    Janne E. M. Koivumäki, Jérôme Thevenot, Pasi Pulkkinen & Timo Jämsä

  2. Department of Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland

    Janne E. M. Koivumäki & Jukka A. Salmi

  3. Department of Trauma Surgery and Sports Medicine, Medical University, Innsbruck, Austria

    Volker Kuhn

  4. Institute of Anatomy, LMU München, Munich, Germany

    Volker Kuhn & Felix Eckstein

  5. Department of Gynecology I, LMU München, Munich, Germany

    Volker Kuhn & Eva-Maria Lochmüller

  6. Department of Radiology, University of California, San Francisco, San Francisco, CA, USA

    Thomas M. Link

  7. Institute of Anatomy and Musculoskeletal Research, Paracelcus Medical University, Salzburg, Austria

    Felix Eckstein

  8. Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland

    Timo Jämsä

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  1. Janne E. M. Koivumäki
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  2. Jérôme Thevenot
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Correspondence to Janne E. M. Koivumäki.

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Koivumäki, J.E.M., Thevenot, J., Pulkkinen, P. et al. Does femoral strain distribution coincide with the occurrence of cervical versus trochanteric hip fractures? An experimental finite element study. Med Biol Eng Comput 48, 711–717 (2010). https://doi.org/10.1007/s11517-010-0622-1

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  • DOI: https://doi.org/10.1007/s11517-010-0622-1

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