Identification of High Stress and Strain Regions in Proximal Femur during Single-Leg Stance and Sideways Fall Using QCT-Based Finite Element Model

Studying stress and strain trends in the femur and recognizing femur failure mechanism is very important for preventing hip fracture in the elderly. The aim of this study was to identify high stress and strain regions in the femur during normal walking and falling to find the mechanical behavior and failure mechanism of the femur. We developed a finite element model of the femur from the subject’s quantitative computed tomography (QCT) image and used it to identify potentially high stress and strain regions during the single-leg stance and the sideways fall. It was found that fracture may initiate from the superior region of femoral neck and propagate to the inferior region during a high impact force such as sideways fall. The results of this study showed that the femur bone is more sensitive to strain than stress which indicates the effect of strain, in addition to effect of stress, should be considered for failure analysis.

Finite Element Prediction of Hip Fracture during a Sideways Fall

Finite element method was applied to model damage development in the femoral neck during a sideways fall. The femoral failure was simulated using the maximum principal strain criterion. The evolution of damage was consistent with previous studies. It was initiated by compressive failure at the junction of the superior aspect of the femoral neck and the greater trochanter. It was followed by tensile failure that occurred at the inferior aspect of the femoral neck before a complete transcervical fracture was observed. The estimated failure line was less than 50° from the horizontal plane (Pauwels type II).