Center for Applied Biomechanics, University of Virginia, Charlottesville, Virginia.
Toyota Collaborative Safety Research Center, Ann Arbor, Michigan.
Traffic Inj Prev. 2024;25(sup1):S145-S150. doi: 10.1080/15389588.2024.2406418. Epub 2024 Nov 1.
This study quantified the local fracture tolerance of the distal fibula. The purpose of this data is to refine the understanding of ankle fracture tolerance in the population and enhance injury prediction by computational tools.
Fracture patterns of the fibula were obtained from the US National Highway Traffic Safety Administration (NHTSA) Crash Injury Research Engineering Network (CIREN). Of 143 cases of ankle injury, 120 included fibula fracture, many of which accompanied by radiology images. The most common fibula fracture type was a Weber C fracture, which was then used as the testing target to replicate with postmortem human surrogates. Isolated distal fibulae (male and female, across a wide anthropometric range) were subjected to quasi-static lateral-medial four-point bending superimposed on axial precompression.
Of the 20 specimens tested, 17 fractured in compression and bending, two fractured in compression, bending, and shear, and one did not fracture upon the imposed displacement. Fractures occurring outside of the target testing span were treated as right-censored data points. Fracture patterns varied among specimens, with oblique fractures being most common, followed by segmental fractures. At failure, compressive force ranged from 77 N to 370 N and bending moment from 17 Nm to 47 Nm.
From the 19 fractured specimens, the variety of fracture patterns observed were generally consistent with the range of fibula fracture types and locations commonly observed in the field. While comparative studies with fibula specimens are largely absent from literature, comparison of this study to other long bones (radius and ulna) show that bending moment at fracture is similar. To the author's knowledge, this is the first study to quantify the fracture tolerance of isolated distal fibulae under loading conditions representative of ankle injury mechanisms in motor vehicle collisions. By combining the results of this study with complementary results from parallel tibia-focused experiments (currently in-press), these results will aid development of tissue-level lower leg fracture prediction of human body models, thus enhancing prediction of ankle injury during safety assessment simulations. Specifically, the fracture tolerance information might generate an injury risk function to guide tissue-level injury prediction with human body models.
本研究量化了腓骨远端的局部骨折耐受性。该数据的目的是细化人群中踝关节骨折耐受性的认识，并通过计算工具增强损伤预测。
美国国家公路交通安全管理局（NHTSA）碰撞伤害研究工程网络（CIREN）获得了腓骨骨折的骨折模式。在 143 例踝关节损伤病例中，120 例伴有腓骨骨折，其中许多伴有放射学图像。最常见的腓骨骨折类型是 Weber C 型骨折，然后将其用作测试目标，用尸体替代物进行复制。对分离的远端腓骨（男女，跨越广泛的人体测量范围）进行准静态侧向 - 内侧四点弯曲叠加轴向预压缩。
在 20 个测试样本中，17 个在压缩和弯曲时发生骨折，2 个在压缩、弯曲和剪切时发生骨折，1 个在施加的位移下未发生骨折。发生在目标测试跨度之外的骨折模式被视为右删失数据点。在样本之间，骨折模式各不相同，最常见的是斜形骨折，其次是节段性骨折。在失效时，压缩力范围为 77N 至 370N，弯矩范围为 17Nm 至 47Nm。
在 19 个骨折样本中，观察到的骨折模式的多样性通常与现场常见的腓骨骨折类型和位置范围一致。虽然文献中基本没有腓骨标本的比较研究，但将本研究与其他长骨（桡骨和尺骨）进行比较表明，骨折时的弯矩相似。据作者所知，这是第一项量化在汽车碰撞中踝关节损伤机制代表的加载条件下分离的远端腓骨的骨折耐受性的研究。通过将本研究的结果与平行的胫骨重点实验的补充结果相结合（目前正在出版中），这些结果将有助于开发人体模型的下肢组织水平骨折预测，从而增强安全评估模拟中的踝关节损伤预测。具体来说，骨折耐受性信息可能会生成一个损伤风险函数，以指导人体模型的组织水平损伤预测。
