High-speed x-ray characterizes fracture incidence and bone-implant motion during a fall from standing

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-05-14 DOI:10.1016/j.clinbiomech.2025.106556

Emily K. Bliven , Pierre Guy , Alexander Baker , Anita Fung , Benedikt Helgason , Peter A. Cripton

{"title":"High-speed x-ray characterizes fracture incidence and bone-implant motion during a fall from standing","authors":"Emily K. Bliven , Pierre Guy , Alexander Baker , Anita Fung , Benedikt Helgason , Peter A. Cripton","doi":"10.1016/j.clinbiomech.2025.106556","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Fall-related traumas like hip fracture are a common yet devastating injury with poor outcomes. Characterizing fracture biomechanics and bone-implant kinematics is essential to increase our understanding of these events to inform treatment and prevention strategies.</div></div><div><h3>Methods</h3><div>This study developed a bilateral high-speed x-ray methodology for the real-time capture of fracture and kinematic data near the hip during fall impacts. High speed x-ray was applied to capture fall impacts of seven cadaveric pelvis-femur specimens encased in a soft tissue surrogate, using a previously developed method. In these specimens, the intact proximal femur had been prophylactically reinforced with an intramedullary nailing system intended to prevent fragility fractures. The feasibility of extracting 3D kinematic data from x-ray data was investigated.</div></div><div><h3>Findings</h3><div>The HSXR system demonstrated visual clarity and sufficient resolution for capturing skeletal fracture and kinematics. The data in this study revealed fracture and newly-seen deformations of the pelvis, highlighting the ability of the x-ray system to document real-time fracture and kinematic events. Kinematic data in 3D was extracted with sufficient accuracy for one specimen.</div></div><div><h3>Interpretation</h3><div>These results demonstrate the merit of high-speed x-ray for studying periprosthetic fracture, which is of increasing relevance due to increasing populations with orthopedic hardware. Application of this method advances our understanding of impact-related biomechanics and fracture mechanics during a clinically-relevant fall from standing.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106556"},"PeriodicalIF":1.4000,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Biomechanics","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0268003325001299","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Fall-related traumas like hip fracture are a common yet devastating injury with poor outcomes. Characterizing fracture biomechanics and bone-implant kinematics is essential to increase our understanding of these events to inform treatment and prevention strategies.

Methods

This study developed a bilateral high-speed x-ray methodology for the real-time capture of fracture and kinematic data near the hip during fall impacts. High speed x-ray was applied to capture fall impacts of seven cadaveric pelvis-femur specimens encased in a soft tissue surrogate, using a previously developed method. In these specimens, the intact proximal femur had been prophylactically reinforced with an intramedullary nailing system intended to prevent fragility fractures. The feasibility of extracting 3D kinematic data from x-ray data was investigated.

Findings

The HSXR system demonstrated visual clarity and sufficient resolution for capturing skeletal fracture and kinematics. The data in this study revealed fracture and newly-seen deformations of the pelvis, highlighting the ability of the x-ray system to document real-time fracture and kinematic events. Kinematic data in 3D was extracted with sufficient accuracy for one specimen.

Interpretation

These results demonstrate the merit of high-speed x-ray for studying periprosthetic fracture, which is of increasing relevance due to increasing populations with orthopedic hardware. Application of this method advances our understanding of impact-related biomechanics and fracture mechanics during a clinically-relevant fall from standing.

查看原文本刊更多论文

高速x线显示站立跌倒时骨折发生率和植入骨运动的特征

与跌倒相关的创伤，如髋部骨折，是一种常见但后果不佳的破坏性损伤。表征骨折生物力学和骨植入物运动学对于提高我们对这些事件的理解，为治疗和预防策略提供信息至关重要。方法：本研究开发了一种双侧高速x线方法，用于在跌倒碰撞时实时捕获髋部附近的骨折和运动学数据。采用先前开发的方法，采用高速x射线捕捉包裹在软组织替代物中的7具尸体骨盆-股骨标本的坠落冲击。在这些标本中，完整的股骨近端已预防性加固髓内钉系统，以防止易碎性骨折。研究了从x射线数据中提取三维运动数据的可行性。HSXR系统显示了视觉清晰度和足够的分辨率来捕获骨骼骨折和运动学。本研究的数据显示了骨盆骨折和新出现的变形，强调了x射线系统记录实时骨折和运动学事件的能力。以足够的精度提取一个样品的三维运动数据。这些结果证明了高速x射线在研究假体周围骨折方面的优点，由于骨科硬件的使用越来越多，这一点越来越重要。该方法的应用促进了我们对与站立跌倒相关的撞击相关生物力学和骨折力学的理解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.