We hypothesize that variations of body anthropometry, conjointly with the bone strength, determine the risk of hip fracture. To test the hypothesis, we compared, in a simulated sideways fall, the hip impact energy to the energy needed to fracture the femur. Ten femurs from elderly donors were tested using a novel drop-tower protocol for replicating the hip fracture dynamics during a fall on the side. The impact energy was varied for each femur according to the donor’s body weight, height and soft-tissue thickness, by adjusting the drop height and mass. The fracture pattern, force, energy, strain in the superior femoral neck, bone morphology and microarchitecture were evaluated. Fracture patterns were consistent with clinically relevant hip fractures, and the superior neck strains and timings were comparable with the literature. The hip impact energy (11 – 95 J) and the fracture energy (11 – 39 J) ranges overlapped and showed comparable variance (CV = 69 and 61%, respectively). The aBMD-based definition of osteoporosis correctly classified 7 (70%) fracture/non-fracture cases. The incorrectly classified cases presented large impact energy variations, morphology variations and large subcortical voids as seen in microcomputed tomography. In conclusion, the risk of osteoporotic hip fracture in a sideways fall depends on both body anthropometry and bone strength.

我们假设人体测量学的变化与骨骼强度共同决定了髋部骨折的风险。为了验证这个假设，我们在模拟的侧身跌倒中比较了髋部撞击能量与股骨骨折所需的能量。来自老年捐赠者的 10 块股骨使用一种新颖的落塔方案进行了测试，以复制侧面跌倒期间的髋部骨折动力学。根据供体的体重、身高和软组织厚度，通过调整跌落高度和质量，每个股骨的冲击能量是不同的。评估了股骨上颈的骨折模式、力、能量、应变、骨形态和微结构。骨折模式与临床相关的髋部骨折一致，颈部应变和时间与文献相当。髋部冲击能量 (11 – 95 J) 和断裂能量 (11 – 39 J) 范围重叠并显示出相当的差异（分别为 CV = 69 和 61%）。基于 aBMD 的骨质疏松症定义正确分类了 7 (70%) 例骨折/非骨折病例。如显微计算机断层扫描中所见，错误分类的病例呈现出大的冲击能量变化、形态变化和大的皮质下空隙。总之，侧身跌倒时骨质疏松性髋部骨折的风险取决于人体测量学和骨骼强度。在显微计算机断层扫描中看到的形态变化和大的皮质下空隙。总之，侧身跌倒时骨质疏松性髋部骨折的风险取决于人体测量学和骨骼强度。在显微计算机断层扫描中看到的形态变化和大的皮质下空隙。总之，侧身跌倒时骨质疏松性髋部骨折的风险取决于人体测量学和骨骼强度。