Femoral fracture type can be predicted from femoral structure: a finite element study validated by digital volume correlation experiments
File(s)Ridzwan_et_al-2017-Journal_of_Orthopaedic_Research.pdf (1.56 MB)
Accepted version
Author(s)
Type
Journal Article
Abstract
Proximal femoral fractures can be categorized into two main types: Neck and intertrochanteric fractures accounting for 53% and 43% of all proximal femoral fractures, respectively. The possibility to predict the type of fracture a specific patient is predisposed to would allow drug and exercise therapies, hip protector design, and prophylactic surgery to be better targeted for this patient rendering fracture preventing strategies more effective. This study hypothesized that the type of fracture is closely related to the patient-specific femoral structure and predictable by finite element (FE) methods. Fourteen femora were DXA scanned, CT scanned, and mechanically tested to fracture. FE-predicted fracture patterns were compared to experimentally observed fracture patterns. Measurements of strain patterns to explain neck and intertrochanteric fracture patterns were performed using a digital volume correlation (DVC) technique and compared to FE-predicted strains and experimentally observed fracture patterns. Although loaded identically, the femora exhibited different fracture types (six neck and eight intertrochanteric fractures). CT-based FE models matched the experimental observations well (86%) demonstrating that the fracture type can be predicted. DVC-measured and FE-predicted strains showed obvious consistency. Neither DXA-based BMD nor any morphologic characteristics such as neck diameter, femoral neck length, or neck shaft angle were associated with fracture type. In conclusion, patient-specific femoral structure correlates with fracture type and FE analyses were able to predict these fracture types. Also, the demonstration of FE and DVC as metrics of the strains in bones may be of substantial clinical value, informing treatment strategies and device selection and design.
Date Issued
2017-08-01
Date Acceptance
2017-07-24
Citation
Journal of Orthopaedic Research, 2017, 36 (3), pp.993-1001
ISSN
1554-527X
Publisher
Wiley
Start Page
993
End Page
1001
Journal / Book Title
Journal of Orthopaedic Research
Volume
36
Issue
3
Copyright Statement
© 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. This is the peer reviewed version of the following article: Ridzwan, M. I. Z., Sukjamsri, C., Pal, B., van Arkel, R. J., Bell, A., Khanna, M., Baskaradas, A., Abel, R., Boughton, O., Cobb, J. and Hansen, U. N. (2017), Femoral fracture type can be predicted from femoral structure: A finite element study validated by digital volume correlation experiments. J. Orthop. Res.. doi:10.1002/jor.23669, which has been published in final form at https://dx.doi.org/10.1002/jor.23669. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
Royal College Of Surgeons Of England
Grant Number
RDB04 79560
WSSU_P63898
Subjects
digital volume correlation
finite element analysis
fracture
intertrochanteric
neck
0903 Biomedical Engineering
1103 Clinical Sciences
1106 Human Movement And Sports Science
Orthopedics
Publication Status
Published