Fracture Patterns in the Femur from Blunt Force Trauma

摘要

Research investigating the expected fracture patterns in the human femur from angular forces regarded as blunt force trauma remains inconsistent. The purpose of the study is to demonstrate fracture patterns in a human femur in the mid stance phase of gait with a research design that includes surrounding soft tissues and appropriate forces acting on a human femur in that phase of the gait cycle. Twenty human cadaveric fresh-frozen, unfixed, disarticulated femora from the Saint Louis University Center for Anatomical Science and Education (C.A.S.E.) Donated Body Program were used in the study. No fixative was used in order to closely reflect normal tissue composition. Ten normal condition femora were harvested and ten osteoporotic condition femora were harvested. Individual specimens were placed in an apparatus to replicate stance position and an angular force that stimulates blunt force trauma was used to strike the middle of the thigh when under compression. Two separate trials were completed which employed the determined angular force. A first set of ten specimens retained all their tissue and each was subjected to the angular force. A second set of ten specimens in which all soft tissue was removed through careful dissection was subjected to the angular force. Results of this study differ from previous studies. This study did not demonstrate a consistent fracture pattern and multiple types of complete fractures were demonstrated. This study demonstrates that the density of the bone impacts whether a fracture will occur. The different fracture patterns produced in this study indicate that both bone density and preservation may influence the production of fracture patterns. It can be suggested that the presence of soft tissue may also greatly influence a fracture pattern and therefore must be considered when pursuing blunt force trauma fracture analysis. Additionally, this research emphasizes that any impact that surrounding soft tissue has in inhibiting fracture should be considered. This study emphasizes an important need for additional research with models that incorporate the various forces discussed to accurately evaluate a human femur in situ when exposed to angular trauma.