Risk of fracture in elderly patients: a new predictive index based on bone mineral density and finite element analysis

Comput Methods Programs Biomed. 1999 Jul;60(1):23-33. doi: 10.1016/s0169-2607(99)00007-3.

Abstract

Hip fracture is more and more frequent in elderly population. For this reason, an increasing attention has been focused on the development of a non-invasive method to predict femoral neck fracture. A conventional approach to fracture diagnosis is the measurement of bone mass by dual-energy X-ray absorptiometry in some regions of interest. The aim of this work is to assess a method that accounts for the structural details of the bone providing a more direct determination of strength properties, and improving the diagnostic power of the current densitometric systems. A 2D finite element model of the proximal femur is derived from dual-energy X-ray absorptiometry data. Initially, the method is validated in vitro using a replica of the human femur. The predicted results are compared to strain-gauge measurements and to a 3D finite element model, with good agreement being observed. Then, an in vivo preliminary study on a limited group of patients is carried out. The loading condition that simulates a fall to the side onto the greater trochanter from standing height is employed. All simulations show a peak strain at the femoral neck region with a strain distribution typical of a fall on the side. The proposed method seems to supply a useful tool for the in vivo analysis of the risk of hip fracture.

MeSH terms

  • Aged
  • Bone Density*
  • Computer Simulation
  • Femoral Neck Fractures / physiopathology*
  • Finite Element Analysis*
  • Humans
  • Models, Biological
  • Predictive Value of Tests
  • Risk Factors