{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:17:51Z","timestamp":1792840671884,"version":"4.5.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2007,6,1]],"date-time":"2007-06-01T00:00:00Z","timestamp":1180656000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We compared trochanteric soft tissue thickness, femoral aBMD, and the ratio of fall force to femoral strength (i.e., factor of risk) in 21 postmenopausal women with incident hip fracture and 42 age-matched controls. Reduced trochanteric soft tissue thickness, low femoral aBMD, and increased ratio of fall force to femoral strength (i.e., factor of risk) were associated with increased risk of hip fracture.<\/jats:p>\n               <jats:p>Introduction: The contribution of trochanteric soft tissue thickness to hip fracture risk is incompletely understood. A biomechanical approach to assessing hip fracture risk that compares forces applied to the hip during a sideways fall to femoral strength may by improved by incorporating the force-attenuating effects of trochanteric soft tissues.<\/jats:p>\n               <jats:p>Materials and Methods: We determined the relationship between femoral areal BMD (aBMD) and femoral failure load in 49 human cadaveric specimens, 53\u201399 yr of age. We compared femoral aBMD, trochanteric soft tissue thickness, and the ratio of fall forces to bone strength (i.e., the factor of risk for hip fracture, \u03a6), before and after accounting for the force-attenuating properties of trochanteric soft tissue in 21 postmenopausal women with incident hip fracture and 42 age-matched controls.<\/jats:p>\n               <jats:p>Results: Femoral aBMD correlated strongly with femoral failure load (r2 = 0.73\u20130.83). Age, height, and weight did not differ; however, women with hip fracture had lower total femur aBMD (OR = 2.06; 95% CI, 1.19\u20133.56) and trochanteric soft tissue thickness (OR = 1.82; 95% CI, 1.01, 3.31). Incorporation of trochanteric soft tissue thickness measurements reduced the estimates of fall forces by \u223c50%. After accounting for force-attenuating properties of trochanteric soft tissue, the ratio of fall forces to femoral strength was 50% higher in cases than controls (0.92 \u00b1 0.44 versus 0.65 \u00b1 0.50, respectively; p = 0.04).<\/jats:p>\n               <jats:p>Conclusions: It is possible to compute a biomechanically based estimate of hip fracture risk by combining estimates of femoral strength based on an empirical relationship between femoral aBMD and bone strength in cadaveric femora, along with estimates of loads applied to the hip during a sideways fall that account for thickness of trochanteric soft tissues. Our findings suggest that trochanteric soft tissue thickness may influence hip fracture risk by attenuating forces applied to the femur during a sideways fall and provide rationale for developing improved measurements of trochanteric soft tissue and for studying a larger cohort to determine whether trochanteric soft tissue thickness contributes to hip fracture risk independently of aBMD.<\/jats:p>","DOI":"10.1359\/jbmr.070309","type":"journal-article","created":{"date-parts":[[2007,3,12]],"date-time":"2007-03-12T14:50:09Z","timestamp":1173711009000},"page":"825-831","source":"Crossref","is-referenced-by-count":194,"title":["Contribution of Trochanteric Soft Tissues to Fall Force Estimates, the Factor of Risk, and Prediction of Hip Fracture Risk*"],"prefix":"10.1093","volume":"22","author":[{"given":"Mary L","family":"Bouxsein","sequence":"first","affiliation":[{"name":"Orthopedic Biomechanics Laboratory, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawel","family":"Szulc","sequence":"additional","affiliation":[{"name":"INSERM Research Unit 403 and Department of Rheumatology, Universit\u00e9 Claude Bernard, H\u00f4pital Edouard Herriot, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fracoise","family":"Munoz","sequence":"additional","affiliation":[{"name":"INSERM Research Unit 403 and Department of Rheumatology, Universit\u00e9 Claude Bernard, H\u00f4pital Edouard Herriot, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Thrall","sequence":"additional","affiliation":[{"name":"Orthopedic Biomechanics Laboratory, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Sornay-Rendu","sequence":"additional","affiliation":[{"name":"INSERM Research Unit 403 and Department of Rheumatology, Universit\u00e9 Claude Bernard, H\u00f4pital Edouard Herriot, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre D","family":"Delmas","sequence":"additional","affiliation":[{"name":"INSERM Research Unit 403 and Department of Rheumatology, Universit\u00e9 Claude Bernard, H\u00f4pital Edouard Herriot, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,12,4]]},"reference":[{"key":"2024020319295513100_bib1","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1056\/NEJM199503233321202","article-title":"Risk factors for hip fracture in white women","volume":"332","author":"Cummings","year":"1995","journal-title":"N Engl J Med"},{"key":"2024020319295513100_bib2","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1007\/s00198-005-1863-y","article-title":"Body mass index as a predictor of fracture risk: A meta-analysis","volume":"16","author":"De Laet","year":"2005","journal-title":"Osteoporos Int"},{"key":"2024020319295513100_bib3","first-page":"101","article-title":"Falls and fractures in postmenopausal women: A review","volume":"9","author":"Geusens","year":"2003","journal-title":"J Br Menopause Soc"},{"key":"2024020319295513100_bib4","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1056\/NEJM199105093241905","article-title":"Risk factors for falls as a cause of hip fracture in women. 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