Effect of Impact Velocity, Flooring Material, and Trochanteric Soft-Tissue Quality on Acetabular Fracture during a Sideways Fall: A Parametric Finite Element Approach

Shahab Khakpour,Rami K Korhonen,Timo Jämsä,Simo Saarakkala,Amir Esrafilian,Mika E Mononen,Petri Tanska

doi:10.3390/app11010365

Shahab Khakpour, Rami K Korhonen + Show 5 more

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https://doi.org/10.3390/app11010365

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Abstract

A low-energy acetabular fracture, as a result of falling from standing height, is common among elderly patients and the number of cases is increasing rapidly in developed countries. Several biomechanical factors contribute to the incidence, severity, and type of acetabular fractures, such as body configuration at the impact moment or bone and soft-tissue quality. The current parametric study developed a comprehensive finite element model of the pelvic girdle and simple representation of the whole body and investigated the effects of impact velocity, conventional indoor/outdoor flooring material, and trochanteric soft-tissue stiffness on an acetabular fracture. Our results show that whereas the impact velocity has a substantial influence on the incidence and type of acetabular fracture, the effects of conventional flooring materials and trochanteric soft-tissue quality are not remarkable. It seems that other factors such as the quality of bone (healthy vs. osteoporotic), the thickness of trochanteric soft-tissue, and body configuration at the impact are more critical in the occurrence and type of the acetabular fracture. These results can be valuable in the prevention of acetabular fractures and the design of protective measures such as hip pads or novel flooring materials.

Highlights

The incidence of low-energy fractures of the acetabulum has increased substantially (2.4-fold) in developed countries during recent decades [1,2,3]
Low-energy acetabular fractures are common among the geriatric population, and in most cases, they happen due to sideways falling [4,5], when the trochanteric soft tissue (TST) hits the ground and the impact force is transmitted through the femoral neck and head to the acetabulum [6,7]
The effects of VImpact, flooring material, and TST stiffness on the ground reaction force (GRF), maximum joint internal reaction forces (IRFmax ) [13], and bone failure pattern by comparing the failed elements location with Judet and Letournel’s classification [6], (Appendix A, Figure A5) are presented here

Summary

Introduction

The incidence of low-energy fractures (e.g., falling from standing height) of the acetabulum has increased substantially (2.4-fold) in developed countries during recent decades [1,2,3]. Low-energy acetabular fractures are common among the geriatric population, and in most cases, they happen due to sideways falling [4,5], when the trochanteric soft tissue (TST) hits the ground and the impact force is transmitted through the femoral neck and head to the acetabulum [6,7]. Many factors such as bone and soft-tissue quality and body configuration during impact can affect the incidence, severity, and type of low-energy acetabular fractures [2,8,9]. Shim et al [20] studied the acetabular fracture for standing and seating positions and reported the corresponding fracture loads as 3200 and

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