Prediction of proximal femur strength using a CT-based nonlinear finite element method: Differences in predicted fracture load and site with changing load and boundary conditions

Exercise loading history and femoral neck strength in a sideways fall: A three-dimensional finite element modeling study

“…While QCT would have provided high-resolution image data on femoral neck geometry and bone apparent density, MR imaging has been found to be adequately valid for the assessment of cortical geometry [25,62]. The pixel size in the previous QCTbased proximal femur studies [13,19,20] has been around 0.5 mm in contrast to the 0.9 mm pixel size in the present study. Obviously, a higher in-plane resolution would have provided a more accurate segmentation of the cortical bone.…”

“…While the use of QCT-based FE models would have also allowed the estimation of inhomogeneous elastic properties using the voxel-based Hounsfield unit data (density) [11][12][13][18][19][20][21][22], the assumption of homogeneous material properties is acceptable.…”

“…Accordingly, it has been speculated that the fracture initiates from this thin cortical layer of the superolateral region [4,7,8]. Several finite element (FE) modeling and cadaveric experimental studies have consistently shown that a sideways fall exposes the femoral neck to the greatest risk of a fracture [7,[9][10][11][12][13]. Indeed, over 90% of hip fractures are directly caused by falls [14,15].…”

“…However, the influence of this exercise-induced structural benefit on femoral neck strength in the sideways fall was not examined. Several FE modeling studies have been conducted to obtain a better understanding of the hip fracture mechanism [3,6,9,[11][12][13][18][19][20][21][22]. To the best of our knowledge, however, no FE modeling study has so far been conducted to investigate the influence of specific exercise loading…”

Male osteoporosis: A review

“…Concerning finite element (FE) simulation, as alternative tool to predict fracture risk, several works can be found in the literature [77][78][79][80][81][82][83][84][85][86][87] . The development of new techniques for measuring BMD has focused much of the recent research in the clinical setting, but the mechanical aspects have not been adequately studied [88][89][90][91] .…”