title: Influence of Regional Difference in Bone Mineral Density on Hip Fracture Site in Elderly Females by Finite Element Analysis.
abstract: Hip fracture is a kind of osteoporotic fractures in elderly patients. Its important monitoring indicator is to measure bone mineral density (BMD) using DXA. The stress characteristics and material distribution in different parts of the bones can be well simulated by three-dimensional finite element analysis. Our previous studies have demonstrated a linear positive correlation between clinical BMD and the density of three-dimensional finite element model of the femur. However, the correlation between the density variation between intertrochanteric region and collum femoris region of the model and the fracture site has not been studied yet. The present study intends to investigate whether the regional difference in the density of three-dimensional finite element model of the femur can be used to predict hip fracture site in elderly females. The CT data of both hip joints were collected from 16 cases of elderly female patients with hip fractures. Mimics 15.01 software was used to reconstruct the model of proximal femur on the healthy side. Ten kinds of material properties were assigned. In Abaqus 6.12 software, the collum femoris region and intertrochanteric region were, respectively, drawn for calculating the corresponding regional density of the model, followed by prediction of hip fracture site and final comparison with factual fracture site. The intertrochanteric region/collum femoris region density was [(1.20 ± 0.02) × 10(6)] on the fracture site and [(1.22 ± 0.03) × 10(6)] on the non-fracture site, and the difference was statistically significant (P = 0.03). Among 16 established models of proximal femur on the healthy side, 14 models were consistent with the actual fracture sites, one model was inconsistent, and one model was unpredictable, with the coincidence rate of 87.5 %. The intertrochanteric region or collum femoris region with lower BMD is more prone to hip fracture of the type on the corresponding site.
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510405, Guangdong, China. zllin01@163.com.
authors.forename: Z L
authors.initials: ZL
authors.lastname: Lin
authors.affiliation: Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.
authors.forename: P F
authors.initials: PF
authors.lastname: Li
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510405, Guangdong, China.
authors.forename: Z H
authors.initials: ZH
authors.lastname: Pang
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510405, Guangdong, China.
authors.forename: X H
authors.initials: XH
authors.lastname: Zheng
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510405, Guangdong, China.
authors.forename: F
authors.initials: F
authors.lastname: Huang
authors.affiliation: Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.
authors.forename: H H
authors.initials: HH
authors.lastname: Xu
authors.affiliation: Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.
authors.forename: Q L
authors.initials: QL
authors.lastname: Li
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology*; D005260:Female; D005272:Femur Neck / Q000033:anatomy & histology; D020342:Finite Element Analysis; D006620:Hip Fractures / Q000473:pathology*; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008953:Models, Anatomic; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface
keywords: Bone mineral density; Elderly females; Finite element analysis; Hip fracture site