Evidence map›Paper›PMID 35112136›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2022

Association of atypical femoral fracture location and lower limb mechanical axis: a computed tomography-based finite element analysis.

Donghwan Hwang, Chul-Ho Kim, Yongkoo Lee, Ji Wan Kim

Abstract read
PubMed Publisher
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Femur geometry influences atypical femoral fracture location.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Donghwan Hwang *Medical Device Development Center, Daegu-Gyeongbuk Medical Innovation Foundation, Daegu, Republic of Korea.ORCID http://orcid.org/0000-0002-8370-5246
Chul-Ho Kim *Department of Orthopaedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.ORCID http://orcid.org/0000-0001-9233-5358
Yongkoo LeeKorea Institute of Machinery and Materials, Daegu, Republic of Korea.ORCID http://orcid.org/0000-0002-9722-8356
Ji Wan KimDepartment of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea. bakpaker@hanmail.net.ORCID http://orcid.org/0000-0002-3524-8706

Funding

National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) 2021R1A2C1012972
6 · The paper itself

Abstract

Atypical femoral fractures (AFFs) are categorized as low-energy fractures of the femoral shaft or subtrochanteric region. The use of computed tomography-based finite element analysis demonstrated that the femoral weakest point against tensile stress coincided with AFF location, which was determined by the lower limb axis and femoral bowing.

introductionThis study aimed to assess the relationship between the femoral weakest point against tensile stress and the lower limb axis and geometry, including femoral bowing, using a computed tomography (CT)-based finite element analysis (FEA) model.

methodsWe retrospectively reviewed 19 patients with AFFs and analyzed their CT images of the contralateral intact femur. We performed FEA to find the maximum principal stress (MPS) and maximal tensile stress loading area (femoral weakest point, FWP) of each patient and matched the FWP with the real location of AFF. We applied mechanical axes differently, as neutral, varus, and valgus, in the FEA model, when we analyzed the change in MPS and FWP based on lower limb alignment. We compared the degree of agreement between the real fracture location and FWP before and after knee mechanical axis adjustment.

resultsThe average participant age was 75.9 (range, 61-87) years, and all participants were women. In the 19 patients included, we observed 20 and 7 shaft and subtrochanteric AFFs, respectively. The average mechanical axis at the knee joint level was 22.6 mm (range, 0-70 mm) of the varus. All the patients showed an increasing trend of MPS and a distal movement of FWP when the mechanical axis of the knee was applied from the valgus to varus alignment. The root mean square errors between the FWP and real fracture location were 14.58% and 10.87% before and after adjustment, respectively, implying that the degree of agreement was better in patients who underwent mechanical adjustment.

conclusionThe use of CT/FEA demonstrated that the FWP against tensile stress coincided with AFF location, which was determined by the lower limb axis and femoral bowing.

Indexed as

Femoral FracturesAgedAged, 80 and overFemaleFemurFinite Element AnalysisHumansLower ExtremityMaleMiddle AgedRetrospective StudiesTomography, X-Ray ComputedAtypical femur fractureBiomechanicsFinite element analysisInsufficiency fractureLower limb axis.

Identifiers

PMID35112136

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.