Bone Fracture Mechanics

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Bone & Fracture Mechanics

Influence of muscle
Bone behaviour under
activity on stress Bone strength
various loading modes
distribution in bone
Influence of bone geometry on
Rate dependency in bone Fatigue fracture of bone
biomechanical behaviour
Strain Theory of Fracture Effect of movement on bone
Bone Remodelling
Healing healing
Effects of holes on bone
Effects of use and disuse Effects of aging on bone
strength

Bone can be considered as a biphasic composite material, mineral as one phase, and collagen and
ground substance as the other

The combined substances are stronger for their weight than either substance alone

Cortical bone is stiffer than cancellous bone and more brittle, withstanding less strain before failure
than cancellous bone

● Fracture occurs in cortical bone in vitro at strains of only 2%

● Fracture occurs in cancellous bone in vitro at strains of > 75%

Bone is VISCOELASTIC (= time dependent property where the deformation of the material is related
to the rate of loading, hysteresis, creep, stress relaxation)

Load deformation curve for bone compared to other materials = the elastic portion of the graph has a
slight curve in bone.

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Bone stiffness compared to other materials:

Stiffness Curves

Bone behaviour under various loading modes

Bone is ANISOTROPIC (i.e it has different mechanical properties when loaded along different axes).
This is because the structure of bone is dissimilar in the transverse and longitudinal directions

Adult cortical bone is stronger in compression than tension and weakest in shear.

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Most fractures occur as a result of several loading modes

Tension

● At the microscopic level, the failure mechanism for bone loaded in tension is mainly debonding
at the cement lines and pulling out of the osteons

● The type of fracture occurring in tension is a transverse fracture

● Tension #s tend to occur in areas with a large proportion of cancellous bone eg calcaneum, 5th
metatarsal

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Compression

● At the microscopic level the failure mechanism for bone tissue in compression is mainly oblique
cracking of the osteons

● The type of fracture that occurs in compression is an oblique fracture at an angle of 30 degrees
as shear forces at this angle are responsible for the failure.

● There are few fractures which occur purely due to compression

● These fractures tend to occur in the metaphyses of bones where there is more cancellous
bone which is weaker.

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Bending

● In bending there is a combination of compression and tension. Tensile stresses and strains
on one side of the neutral axis and compressive stresses and strains on the other side.
Because bone is assymmetrical, the compressive and tensile stresses may not be equal

● Bending causes transverse fractures as failure on the tension side progresses transversely
across the bone and the neutral axis shifts.

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Three point bending- three forces act on a structure produce 2 equal moments, each being the
product of one of the two peripheral forces and the distance to the axis of rotation (the point at which
the middle force is applied. If loading continues to yield point assuming the structure is homogenous
and symmetrical, it will break at the point of application of the middle force. Fracture begins on the
tension side in adult bone as bone is weaker in tension than compression. Examples include skiboot
fractures of the tibia. In immature bone it may fail by compression causing buckling on the
compression side

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Four point bending- Two force couples acting on a structure produce two equal moments. The
magnitude of the bending moment is the same throughout the area between the two force couples.
The structure will break at its weakest point between them. Eg a previous unhealed fracture.

Compression and bending combined

● A combination of fracture type occurs. Bending produces a transverse crack on the tensile side
of the bone, compression causes an oblique fracture on the other side. Where they meet a
butterfly segment results

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Torsion

● A load is placed on a structure so that twisting occurs about an axis. A torque or moment is
produced within the structure.

● Maximal shear stresses act in planes parallel and perpendicular to the neutral axis

● Maximal tensile and compressive forces act on planes diagonal to the neutral axis

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● The fracture for a bone loaded in torsion is a spiral fracture.

● It begins with failure in shear, with the formation of a crack parallel to the neutral axis of the
bone

● Followed by failure in tension along the line of maximal tensile stress at a diagonal to the axis

Shear

● A structure subjected to shear loading deforms internally in an angular manner, right angles on
a plane surface within the structure become obtuse or acute.

● Whenever a structure is subject to compressive or tensile loading, shear stress is also produced

● The value for the stiffness of a material under shear loading is known as the shear modulus,
not elastic modulus

● Shear fractures tend to occur in cancellous bone eg. Femoral condyles, tibial plateau.

Bone strength

Compression Strongest

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Tension Weak
Shear Weakest

Bone type Load type Elastic modulus (109 N/m2) Ultimate stress (106 N/m2 )

Cortical Compression 15.1 - 19.7 156 - 212

Tension 11.4 - 19.1 107 - 146

Shear 73 - 82

Cancellous Compression 0.1 - 3 1.5 - 50

Tension 0.2 - 5 3 - 20

Shear 6.6

Influence of muscle activity & loading on stress distribution in bone

● When bone is loaded in vivo, simultaneous contraction of surrounding muscles act to oppose
these loads, so that it can withstand higher loads.

Wolff's Law (Julius Wolff, 1884)

● 'form follows function'.

● Bone has the ability to adapt, by changing its size, shape, and structure, to the mechanical
demands placed on it.

● Bone is laid down where needed and resorbed where not needed.

● The remodelling may be either external (a change in the external shape of the bone) or internal
(a change in the porosity, mineral content, and density of bone).

Rate dependency in bone

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● Because bone is viscoelastic, its biomechanical behaviour varies with the rate of application of
forces

● Bone is stiffer and more brittle and can sustain a higher load to failure when loads are applied
at higher rates [Graph]

● Bone also stores more energy to failure before failure at high loading rates. When a bone
fractures the stored energy is released. At a low loading rate the energy can dissipate through
formation of a single crack. At a high loading rate, the greater energy stored cannot be
dissipated rapidly enough through a single crack and comminution and extensive soft tissue
damage result

Fatigue fracture of bone

● Caused by repeated applications of a load below the ultimate strength/stress of the bone

● The fatigue process in living bone is affected by the amount of load, the number of repetitions
and the frequency of loading. Fatigue fracture only occurs when the rate of remodelling is
outpaced by the fatigue process.

● Fatigue fractures tend to occur during continuous strenuous physical activity causing the
muscles to fatigue and reduces their ability to contract and counteract the imposed loading.

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Influence of bone geometry on biomechanical behaviour

In tension and compression,

● The load to failure and stiffness are proportional to the cross sectional area of the bone

In bending,

● The load to failure and the stiffness are proportional to the ‘area moment of inertia.’ This is a
figure which takes into account the cross sectional area and the distribution of bone about the
neutral axis.

● The area moment of inertia for a rectangular block= BxH3/ 12 (B = width H = height)

● Block III is more resistant to bend than block I and II.

● Bones increase their area moment of inertia by distributing most of the bone tissue in the
periphery, away from the neutral axis

● In bending, the load to failure and stiffness is also inversely proportional to the length of the
bone. The longer the bone is, the bigger the bending moment produced for the same force.

● For a tubular structure / cylinder the further the material is from the neutral axis, the stiffer the
construct under a given loads = Second Moment of Area (I)

❍ Circle: I = [pi.r4] /4 (hollow: r= outer radius-inner rad.)

❍ Bending Stiffness = E.I (where E is Youngs Modulus)

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❍ The region of a bone/nail with the smallest I is subjected to the largest deformation under
load & will fail first
❍ Indirect bone healing (thick periosteum) -> incr. I -> incr. stiffness & strength.

In Torsion:

● The load to failure and stiffness are proportional to the Polar Moment of Inertia(J)

● This takes into account the cross sectional area and the distribution of bone tissue around the
neutral axis

● J = [pi/2]x[Ro4-Ri4] = 2.I; T/ø = JG/L (T/ø= torsional stiffness, T= torque, ø= angle of twist, G=
shear modulus, L= length of shaft)

In bone healing:

● Callus formation around the periphery of a fracture increases the Second Moment of Area (I)
and the Polar Moment of Inertia(J) of a bone, thus maximising the strength and stiffness of the
bone in bending and torsion during healing.

Bone remodelling

● Wolff’s law – Bone is laid down where needed and resorbed where not needed

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● Thus disuse leads to supperiosteal and periosteal bone resorption, reducing its stiffness and
strength.

● Stress protection of bone- is a phenomenon whereby an implant, by sharing the imposed load
can cause resorption of the underlying/surrounding bone as this bone carries less load than
normal.

● Bone hypertrophy can also occur at implant attachment sites, eg. Around screws.

● Laying down of bone can occur as a result of strenuous exercise, or resorption can occur in
prolonged weightlessness or inactivity.

Strain Theory of Fracture Healing

● The theory of interfragmentary strain hypothesis is that the type of tissue formed in a healing
gap depends on the strain that it experiences

● If the strain is between:

❍ 10%-100% granulation tissue can be expected to form

❍ 2%-10% fibrocartilage will form

❍ < 2% bone will form

Effect of movement on bone healing

Kenwright et al studied osteotomies with a gap of 3mm and subjected them to movement. They showed
that when compared to a rigidly held osteotomy there was:

● Increased bone mineral content in the gap with movement of 0.5mm (16% strain)

● Decreased bone mineral content in the gap with movement of 2.0mm (66% strain)

It is important to note that it is not compressive load but strain, whether compressive or tensile that
increases bone mineralisation

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Other Factors Affecting Bone Strength

Effects of use and disuse

Rubin and Laynon in an avian model (turkey ulna):

Disuse

● 42 days without functional load decreased bone mineral content to 88% of normal

● Bone is lost from the endosteal surface

Use

● Controlled cyclical loading (as low as 36 cycles per day) produced a hypertrophic response with an
increase of between 140%-150% of normal bone mineral content

● Bone is deposited on the periosteal surface

Effects of holes on bone strength

● The strength of bone is effected by the size and shape of holes

● Holes with sharp corners will reduce the torsional strength of bone to a greater extent than those
with smooth edges due to the stress riser effect associated with sharp corners

● 4 point bending strength decreased to 80% of normal for a hole diameter of 10% of the diameter
of the bone

● Torsional strength is affected when the hole size is greater than 10% of the diameter of the bone

● 20% size hole would reduce the torsional strength to 67% of normal

Changes in bone associated with aging

● Progressive loss of bone density occurs with age

● Young bone is more ductile /less brittle than older bone, so more strain before breakage is
allowed in young bone.

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Related Links:

● Fracture Healing
● Materials in Fracture Fixation
● Implants for Fracture Fixation

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Page Updated on: 10 January 2001 19:46

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