Buchanan Drew, Ural Ani
Department of Mechanical Engineering, Villanova University, 800 Lancaster Avenue, Villanova, PA 19085, USA.
J Biomech Eng. 2010 Aug;132(8):081007. doi: 10.1115/1.4001681.
Distal forearm fracture is one of the most frequently observed osteoporotic fractures, which may occur as a result of low energy falls such as falls from a standing height and may be linked to the osteoporotic nature of the bone, especially in the elderly. In order to prevent the occurrence of radius fractures and their adverse outcomes, understanding the effect of both extrinsic and intrinsic contributors to fracture risk is essential. In this study, a nonlinear fracture mechanics-based finite element model is applied to human radius to assess the influence of extrinsic factors (load orientation and load distribution between scaphoid and lunate) and intrinsic bone properties (age-related changes in fracture properties and bone geometry) on the Colles' fracture load. Seven three-dimensional finite element models of radius were created, and the fracture loads were determined by using cohesive finite element modeling, which explicitly represented the crack and the fracture process zone behavior. The simulation results showed that the load direction with respect to the longitudinal and dorsal axes of the radius influenced the fracture load. The fracture load increased with larger angles between the resultant load and the dorsal axis, and with smaller angles between the resultant load and longitudinal axis. The fracture load also varied as a function of the load ratio between the lunate and scaphoid, however, not as drastically as with the load orientation. The fracture load decreased as the load ratio (lunate/scaphoid) increased. Multiple regression analysis showed that the bone geometry and the load orientation are the most important variables that contribute to the prediction of the fracture load. The findings in this study establish a robust computational fracture risk assessment method that combines the effects of intrinsic properties of bone with extrinsic factors associated with a fall, and may be elemental in the identification of high fracture risk individuals as well as in the development of fracture prevention methods including protective falling techniques. The additional information that this study brings to fracture identification and prevention highlights the promise of fracture mechanics-based finite element modeling in fracture risk assessment.
桡骨远端骨折是最常见的骨质疏松性骨折之一,可能由低能量跌倒(如从站立高度跌落)引起,并且可能与骨骼的骨质疏松性质有关,尤其是在老年人中。为了预防桡骨骨折及其不良后果,了解骨折风险的外在和内在因素的影响至关重要。在本研究中,基于非线性断裂力学的有限元模型被应用于人体桡骨,以评估外在因素(载荷方向以及舟骨和月骨之间的载荷分布)和内在骨特性(与年龄相关的骨折特性和骨几何形状变化)对Colles骨折载荷的影响。创建了七个桡骨的三维有限元模型,并使用内聚有限元建模确定骨折载荷,该建模明确表示了裂纹和骨折过程区的行为。模拟结果表明,相对于桡骨纵轴和背轴的载荷方向会影响骨折载荷。骨折载荷随着合力与背轴之间的角度增大以及合力与纵轴之间的角度减小而增加。骨折载荷也随月骨和舟骨之间的载荷比而变化,然而,变化幅度不如载荷方向那么大。骨折载荷随着载荷比(月骨/舟骨)增加而降低。多元回归分析表明,骨几何形状和载荷方向是预测骨折载荷的最重要变量。本研究的结果建立了一种强大的计算骨折风险评估方法,该方法结合了骨的内在特性与跌倒相关的外在因素的影响,并且在识别高骨折风险个体以及开发包括保护性跌倒技术在内的骨折预防方法方面可能是至关重要的。本研究为骨折识别和预防带来的额外信息凸显了基于断裂力学的有限元建模在骨折风险评估中的前景。