Assessment of hip protectors and corresponding hip fracture risk using stress calculation in the femoral neck

Spierings, Adriaan B.; Derler, S.

doi:10.1016/j.medengphy.2005.09.001

Cited by 13 publications

(7 citation statements)

References 68 publications

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“…Alternative outcomes, such as energy absorption in the bone or peak stress (or strain) generated during impact [51], are currently less attractive given our more limited understanding of the energy absorption or state of stress required to cause failure of the proximal femur.…”

Section: Resultsmentioning

confidence: 99%

Hip protectors: recommendations for biomechanical testing—an international consensus statement (part I)

et al. 2009

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Introduction Hip protectors represent a promising strategy for preventing fall-related hip fractures. However, clinical trials have yielded conflicting results due, in part, to lack of agreement on techniques for measuring and optimizing the biomechanical performance of hip protectors as a prerequisite to clinical trials. Methods In November 2007, the International Hip Protector Research Group met in Copenhagen to address barriers to the clinical effectiveness of hip protectors. This paper represents an evidence-based consensus statement from the group on recommended methods for evaluating the biomechanical performance of hip protectors. Results and conclusions The primary outcome of testing should be the percent reduction (compared with the unpadded condition) in peak value of the axial compressive force applied to the femoral neck during a simulated fall on the greater trochanter. To provide reasonable results, the test system should accurately simulate the pelvic anatomy, and the impact velocity (3.4 m/s), pelvic stiffness (acceptable range: 39–55 kN/m), and effective mass of the body (acceptable range: 22–33 kg) during impact. Given the current lack of clear evidence regarding the clinical efficacy of specific hip protectors, the primary value of biomechanical testing at present is to compare the protective value of different products, as opposed to rejecting or accepting specific devices for market use.

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Section: Resultsmentioning

confidence: 99%

Hip protectors: recommendations for biomechanical testing—an international consensus statement (part I)

et al. 2009

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“…In the same year, total expenditures for cardiovascular drugs represented 32% of the total [2]. Other measures to prevent hip fractures could be the promotion of healthy lifestyles and physical activity and the use of hip protectors [38][39][40][41][42][43][44]. Further studies, including pharmaeconomic simulations, should determine if the adoption of proper preventive measures (not exclusively pharmacological ones) in high-risk patients (i.e., people with previous vertebral fractures and patients taking corticosteroid drugs) can decrease the incidence of hip fractures without a major impact on general costs.…”

Section: Discussionmentioning

confidence: 99%

Incidence and costs of hip fractures compared to acute myocardial infarction in the Italian population: a 4-year survey

et al. 2006

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“…40 The load that the femur is subjected to depends on factors specific for the faller, such as soft tissue thickness over the greater trochanter, 3,44 stiffness, 42 and shape, 9 but also on biomechanical aspects of the fall such as impact velocity, impact region, and impact direction. 6,14,28,40,50,51 While hip protectors have been implemented to attenuate impact forces in case of a fall, 9,29,42,47,49 clinical studies investigating their effectiveness have revealed conflicting results. 24,45 One contributing factor may relate to hip protector design.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Fall Direction and Hip Protector on Fracture Risk: FE Model Predictions Driven by Experimental Data

et al. 2022

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Hip fractures in older adults, which often lead to lasting impairments and an increased risk of mortality, are a major public health concern. Hip fracture risk is multi-factorial, affected by the risk of falling, the load acting on the femur, and the load the femur can withstand. This study investigates the influence of impact direction on hip fracture risk and hip protector efficacy. We simulated falls for 4 subjects, in 7 different impact directions (15° and 30° anterior, lateral, and 15°, 30°, 60°, and 90° posterior) at two different impact velocities (2.1 and 3.1 m/s), all with and without hip protector, using previously validated biofidelic finite element models. We found the highest number of fractures and highest fragility ratios in lateral and 15° posterior impacts. The hip protector attenuated femur forces by 23–49 % for slim subjects under impact directions that resulted in fractures (30° anterior to 30° posterior). The hip protector prevented all fractures (6/6) for 2.1 m/s impacts, but only 10% of fractures for 3.1 m/s impacts. Our results provide evidence that, regarding hip fracture risk, posterior-lateral impacts are as dangerous as lateral impacts, and they support the efficacy of soft-shell hip protectors for anterior- and posterior-lateral impacts.

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Assessment of hip protectors and corresponding hip fracture risk using stress calculation in the femoral neck

Cited by 13 publications

References 68 publications

Hip protectors: recommendations for biomechanical testing—an international consensus statement (part I)

Hip protectors: recommendations for biomechanical testing—an international consensus statement (part I)

Incidence and costs of hip fractures compared to acute myocardial infarction in the Italian population: a 4-year survey

The Influence of Fall Direction and Hip Protector on Fracture Risk: FE Model Predictions Driven by Experimental Data

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