{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T22:22:13Z","timestamp":1779229333359,"version":"3.51.4"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"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":[[2009,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Several DXA-based structural engineering models (SEMs) of the proximal femur have been developed to estimate stress caused by sideway falls. Their usefulness in discriminating hip fracture has not yet been established and we therefore evaluated these models. The hip DXA scans of 51 postmenopausal women with hip fracture (30 femoral neck, 17 trochanteric, and 4 unspecified) and 153 age-, height-, and weight-matched controls were reanalyzed using a special version of Hologic's software that produced a pixel-by-pixel BMD map. For each map, a curved-beam, a curved composite-beam, and a finite element model were generated to calculate stress within the bone when falling sideways. An index of fracture risk (IFR) was defined over the femoral neck, trochanter, and total hip as the stress divided by the yield stress at each pixel and averaged over the regions of interest. Hip structure analysis (HSA) was also performed using Hologic APEX analysis software. Hip BMD and almost all parameters derived from HSA and SEM were discriminators of hip fracture on their own because their ORs were significantly &amp;gt;1. Because of the high correlation of total hip BMD to HSA and SEM-derived parameters, only the bone width discriminated hip fracture independently from total hip BMD. Judged by the area under the receiver operating characteristics curve, the trochanteric IFR derived from the finite element model was significant better than total hip BMD alone and similar to the total hip BMD plus bone width in discriminating all hip fracture and femoral neck fracture. No index was better than total hip BMD for discriminating trochanteric fractures. In conclusion, the finite element model has the potential to replace hip BMD in discriminating hip fractures.<\/jats:p>","DOI":"10.1359\/jbmr.080906","type":"journal-article","created":{"date-parts":[[2008,9,3]],"date-time":"2008-09-03T14:52:54Z","timestamp":1220453574000},"page":"33-42","source":"Crossref","is-referenced-by-count":62,"title":["Use of DXA-Based Structural Engineering Models of the Proximal Femur to Discriminate Hip Fracture"],"prefix":"10.1093","volume":"24","author":[{"given":"Lang","family":"Yang","sequence":"first","affiliation":[{"name":"Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Peel","sequence":"additional","affiliation":[{"name":"Metabolic Bone Centre, Northern General Hospital, Sheffield, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jackie A","family":"Clowes","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene V","family":"McCloskey","sequence":"additional","affiliation":[{"name":"Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Eastell","sequence":"additional","affiliation":[{"name":"Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2009,12,4]]},"reference":[{"key":"2024020320061878600_bib1","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s00198-004-1661-y","article-title":"Risk factors for hip fracture in women with high BMD: EPIDOS study","volume":"16","author":"Robbins","year":"2005","journal-title":"Osteoporos Int"},{"key":"2024020320061878600_bib2","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.bone.2003.10.001","article-title":"Fracture incidence and association with bone mineral density in elderly men and women: The Rotterdam Study","volume":"34","author":"Schuit","year":"2004","journal-title":"Bone"},{"key":"2024020320061878600_bib3","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1002\/jbmr.5650081008","article-title":"Simple measurement of femoral geometry predicts hip fracture: The study of osteoporotic fractures","volume":"8","author":"Faulkner","year":"1993","journal-title":"J Bone Miner Res"},{"key":"2024020320061878600_bib4","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/BF02106096","article-title":"Better discrimination of hip fracture using bone density, geometry and architecture","volume":"5","author":"Peacock","year":"1995","journal-title":"Osteoporos Int"},{"key":"2024020320061878600_bib5","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/8756-3282(96)00004-X","article-title":"Femoral neck geometry and radiographic signs of osteoporosis as predictors of hip fracture","volume":"18","author":"Karlsson","year":"1996","journal-title":"Bone"},{"key":"2024020320061878600_bib6","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1359\/jbmr.1997.12.11.1895","article-title":"Different morphometric and densitometric parameters predict cervical and trochanteric hip fracture: The EPIDOS Study","volume":"12","author":"Duboeuf","year":"1997","journal-title":"J Bone Miner Res"},{"key":"2024020320061878600_bib7","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s001980050059","article-title":"Bone mass and structure at the hip in men and women over the age of 60 years","volume":"8","author":"Peacock","year":"1998","journal-title":"Osteoporos Int"},{"key":"2024020320061878600_bib8","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1259\/bjr.72.860.10624337","article-title":"Geometry of proximal femur in the prediction of hip fracture in osteoporotic women","volume":"72","author":"Gnudi","year":"1999","journal-title":"Br J Radiol"},{"key":"2024020320061878600_bib9","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1359\/jbmr.1999.14.10.1714","article-title":"Femoral neck length and hip fracture risk","volume":"14","author":"Michelotti","year":"1999","journal-title":"J Bone Miner Res"},{"key":"2024020320061878600_bib10","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1007\/s001980070071","article-title":"Femoral bone mineral density, neck-shaft angle and mean femoral neck width as predictors of hip fracture in men and women. 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