Majumder Santanu, Roychowdhury Amit, Pal Subrata
Dept. of Aerospace Engineering & Applied Mechanics, Bengal Engineering and Science University, Shibpur, Howrah 711103, West Bengal, India.
Clin Biomech (Bristol). 2013 Nov-Dec;28(9-10):1034-40. doi: 10.1016/j.clinbiomech.2013.09.008. Epub 2013 Sep 25.
Hip fracture depends on various anthropometric parameters such as trochanteric soft tissue thickness, body height and body weight. The objective was to evaluate the responses to the variations in anthropometric parameters during sideways fall, and to identify the most dominant parameter among them.
Seven finite element models were developed having anthropometric variations in trochanteric soft tissue thickness (5-26 mm), body height (1.70-1.88 m), and body weight (63-93.37 kg). These were simulated for sideways fall with ANSYS-LS-DYNA® code.
Significant effect of trochanteric soft tissue thickness variation was found on 'normalized peak impact force with respect to the body weight' (p=0.004, r²=0.808) and strain ratio (p=0.083, r²=0.829). But, variation in body height was found to be less significant on normalized peak impact force (p=0.478, r²=0.105) and strain ratio (p=0.292, r²=0.217). Same was true for the variation in body weight on normalized peak impact force (p=0.075, r²=0.456) and strain ratio (p=0.857, r²=0.007). The risk factor for fracture was also well correlated to the strain ratio for the inter-trochanteric zone (p<0.0007, r²=0.917) where the most fractures are clinically observed to happen.
Trochanteric soft tissue thickness was found likely to be the most dominant parameter over body height and body weight, signifying that a slimmer elderly person, taller or shorter, with less trochanteric soft tissue thickness should be advised to take preventive measures against hip fracture under sideways fall.
髋部骨折取决于多种人体测量参数,如转子周围软组织厚度、身高和体重。目的是评估在侧方跌倒过程中对人体测量参数变化的反应,并确定其中最主要的参数。
建立了七个有限元模型,其转子周围软组织厚度(5 - 26毫米)、身高(1.70 - 1.88米)和体重(63 - 93.37千克)存在人体测量学差异。使用ANSYS-LS-DYNA®代码对这些模型进行侧方跌倒模拟。
发现转子周围软组织厚度变化对“相对于体重的归一化峰值冲击力”(p = 0.004,r² = 0.808)和应变比(p = 0.083,r² = 0.829)有显著影响。但是,发现身高变化对归一化峰值冲击力(p = 0.478,r² = 0.105)和应变比(p = 0.292,r² = 0.217)的影响较小。体重变化对归一化峰值冲击力(p = 0.075,r² = 0.456)和应变比(p = 0.857,r² = 0.007)的影响也是如此。骨折风险因素也与转子间区域的应变比密切相关(p < 0.0007,r² = 0.917),临床上观察到大多数骨折发生在该区域。
发现转子周围软组织厚度可能是比身高和体重更主要影响因素,这表明对于身材较瘦、无论身高如何且转子周围软组织厚度较小的老年人,建议采取预防措施以防止侧方跌倒时发生髋部骨折。