Are hip fractures caused by falling and breaking or breaking and falling? Photoelastic stress analysis

A quasi-brittle continuum damage finite element model of the human proximal femur based on element deletion

“…Depending on the boundary conditions, femoral geometry and the bone properties, different fracture patterns can be observed experimentally and the one obtained here corresponds to a subcapital fracture with stage II of the Garden classification (complete fracture with non-displacement). The stance configuration has been shown in previous studies to produce maximum shear stresses in the femoral neck region in a manner consistent with clinical subcapital fractures [12,69] similar to the predicted one. This fracture pattern prediction is a useful decision-making tool to assist the surgeon in choosing a patient-specific operative treatment.…”

Homicide in a Horse Barn?

“…The recognition of the antemortem hip fracture in this case was a key to determining the likely sequence of events. Although sometimes easy to overlook, especially at autopsy in the presence of other injuries, observing an apparently shortened and externally‐rotated lower extremity should prompt one to consider the possibility of a trochanteric femoral fracture Deaths related to hip fractures are well‐known and common within the medical examiner/death investigation community, where such deaths are typically considered accidental as they are associated with a fall ; although some argue that the manner of death should be considered natural, related to underlying natural disease (osteoporosis), suggesting that most fractures actually occur prior to the fall, rather than as a result of the fall . While this may, in fact, be the case, it is undeniable that traumatic forces related to standing/walking/turning play a role in these fractures; therefore, ruling these deaths as accidental may be considered reasonable, even if the fractures precede the fall.…”

Investigation of Deaths of Chronically Disabled Persons and Institutionalized Persons

“…For example, elderly persons are at increased risk for hip fractures related to falls, with a subsequent increased risk of morbidity and mortality. When a death results from such a fall, it is common and appropriate to rule the manner of death as accident (71), although some have suggested that, since the fracture may actually occur before the fall, then the appropriate manner of death is natural (72). Another example of an accidental type of death that is more likely in an elderly person is the demented elder who wanders away from the home, only to succumb to hypothermia ( Images 8 and 9 ) (63, 73, 74).…”