Background

Forearm fracture risk can be estimated via factor-of-risk: the ratio of applied impact force to forearm fracture load. Simple techniques are available for estimating impact force associated with a fall; estimating forearm fracture load is more challenging. Our aim was to assess whether failure load estimates of sections of the distal radius (acquired using High-Resolution peripheral Quantitative Computed Tomography and finite element modeling) offer accurate and precise estimates of forearm fracture load.

Methods

We scanned a section of the distal radius of 19 cadaveric forearms (female, mean age 83.7, SD 8.3), and 34 women (75.0, 7.7). Sections were converted to finite element models and failure loads were acquired for different failure criteria. We assessed forearm fracture load using experimental testing simulating a fall on the outstretched hand. We used linear regression to derive relationships between ex vivo forearm fracture load and finite element derived distal radius failure load. We used derived regression coefficients to estimate forearm fracture load, and assessed explained variance and prediction error. We used root-mean-squared coefficients of variation to assess in vivo precision errors of estimated forearm fracture load.

Findings

Failure load estimates of sections of the distal radius, used in conjunction with derived regression coefficients, explained 89–90% of the variance in experimentally-measured forearm fracture load with prediction errors <6.8% and precision errors <5.0%.

Interpretation

Failure load estimates of distal radius sections can reliably estimate forearm fracture load experienced during a fall. Forearm fracture load estimates can be used to improve factor-of-risk predictions for forearm fracture.

中文翻译：

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radius骨远端部分可准确准确地估计前臂的骨折负荷。

背景

前臂骨折的风险可以通过危险因素来估计：施加的冲击力与前臂骨折负荷的比率。可以使用简单的技术来估计与跌倒相关的冲击力。估计前臂骨折负荷更具挑战性。我们的目的是评估远端radius骨部分的失败载荷估计值（使用高分辨率外围定量计算机断层扫描和有限元建模获得）是否能够准确准确地估计前臂骨折的载荷。

方法

我们扫描了19个尸体前臂（女性，平均年龄83.7，SD 8.3）和34位女性（75.0，7.7）的远端radius骨的一部分。将截面转换为有限元模型，并针对不同的破坏准则获取破坏载荷。我们使用模拟伸出的手跌倒的实验测试评估了前臂的骨折负荷。我们使用线性回归来得出离体前臂骨折负荷与有限元衍生的远端radius骨破坏负荷之间的关系。我们使用推导的回归系数来估计前臂骨折负荷，并评估解释的方差和预测误差。我们使用均方根变异系数来评估估计的前臂骨折负荷的体内精确度误差。

发现

远端radius骨截面的失败载荷估计与导出的回归系数结合使用，可以解释实验测量的前臂骨折载荷中89％至90％的方差，其中预测误差<6.8％和精确度误差<5.0％。

解释

远端radius骨截面的失败载荷估算可以可靠地估算跌倒时承受的前臂骨折载荷。前臂骨折负荷估计值可用于改善前臂骨折的危险因素预测。