A biomechanical sorting of clinical risk factors affecting osteoporotic hip fracture

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• 作者：Y. Luo
• 关键词：Biomechanical variables ; Clinical ; biomechanical links ; Clinical risk factors ; Osteoporosis ; Hip fracture
• 刊名：Osteoporosis International
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：27
• 期：2
• 页码：423-439
• 全文大小：756 KB
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• 作者单位：Y. Luo (1) (2) (3)
  
  1. Department of Mechanical Engineering, University of Manitoba, Winnipeg, MB, Canada
  2. Department of Biomedical Engineering, University of Manitoba, Winnipeg, MB, Canada
  3. Department of Anatomy, South Medical University, Guangzhou, China
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Orthopedics
  Gynecology
  Endocrinology
  Rheumatology
  
• 出版者：Springer London
• ISSN：1433-2965

文摘

Osteoporotic fracture has been found associated with many clinical risk factors, and the associations have been explored dominantly by evidence-based and case-control approaches. The major challenges emerging from the studies are the large number of the risk factors, the difficulty in quantification, the incomplete list, and the interdependence of the risk factors. A biomechanical sorting of the risk factors may shed lights on resolving the above issues. Based on the definition of load-strength ratio (LSR), we first identified the four biomechanical variables determining fracture risk, i.e., the risk of fall, impact force, bone quality, and bone geometry. Then, we explored the links between the FRAX clinical risk factors and the biomechanical variables by looking for evidences in the literature. To accurately assess fracture risk, none of the four biomechanical variables can be ignored and their values must be subject-specific. A clinical risk factor contributes to osteoporotic fracture by affecting one or more of the biomechanical variables. A biomechanical variable represents the integral effect from all the clinical risk factors linked to the variable. The clinical risk factors in FRAX mostly stand for bone quality. The other three biomechanical variables are not adequately represented by the clinical risk factors. From the biomechanical viewpoint, most clinical risk factors are interdependent to each other as they affect the same biomechanical variable(s). As biomechanical variables must be expressed in numbers before their use in calculating LSR, the numerical value of a biomechanical variable can be used as a gauge of the linked clinical risk factors to measure their integral effect on fracture risk, which may be more efficient than to study each individual risk factor. Keywords Biomechanical variables Clinical-biomechanical links Clinical risk factors Osteoporosis Hip fracture